# ELIZABETH I WAGNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1457842627
- **Gender:** F
- **Credential:** QMHS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | M.2200245 | OH | Yes |
| 172V00000X | Community Health Worker | — | NULL | — |

## Other

- **Enumeration date:** 05/23/2018
- **Last updated:** 05/10/2023