Individual
EMILIE CLAIRE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1716 FORDEM AVE, MADISON, WI 53704-4604
(608) 221-3511
Mailing address
1716 FORDEM AVE, MADISON, WI 53704-4604
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8108-226
WI
Other
Enumeration date
08/08/2023
Last updated
09/11/2024
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