Individual
ROSHELLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 1140, CHINLE, AZ 86503-1140
(928) 674-6824
Mailing address
PO BOX 566, MANY FARMS, AZ 86538-3566
(505) 625-7762
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14135267-3503
UT
Other
Enumeration date
07/22/2026
Last updated
07/22/2026
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