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Individual
MADISON C WAGNER
Active
Individual
MADISON C WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.189320
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.163017
OH
Other
Enumeration date
08/22/2023
Last updated
06/11/2026
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