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Individual
LINDA WAGNER
Active
Individual
LINDA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SW13683
FL
1041C0700X
Clinical Social Worker
R078023-01
NY
1041C0700X
Clinical Social Worker
Primary
SW13683
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R078023-01
LCSW R
NY
01
—
SW13683
FLORIDA DOH
FL
Enumeration date
07/08/2015
Last updated
07/20/2021
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