# SAMUEL ELIAS WAGNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1285413138
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | 14236326-3502 | UT | Yes |
| 1041S0200X | School Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 09/28/2023
- **Last updated:** 03/31/2026