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Individual
KATELYN WAGNER
Active
Individual
KATELYN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.2004925
OH
1041C0700X
Clinical Social Worker
Primary
I.2304520
OH
1041C0700X
Clinical Social Worker
S.2004925
OH
1041C0700X
Clinical Social Worker
S.200925
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
11/22/2019
Last updated
01/06/2025
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