Individual
NATALIE A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMHP, LADC
Contact information
Practice address
7101 NEWPORT AVE, OMAHA, NE 68152-2164
(402) 572-2916
(402) 572-3258
Mailing address
8901 INDIAN HILLS DR STE 350B, OMAHA, NE 68114-4038
(402) 991-9630
(402) 502-0795
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
482
NE
101YM0800X
Mental Health Counselor
7909
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47083066228
—
NE
Enumeration date
04/10/2007
Last updated
03/24/2020
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