Individual
CARA WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.ED.
Contact information
Practice address
3415 N 59TH AVE, PHOENIX, AZ 85033-4623
(602) 764-2047
Mailing address
3415 N 59TH AVE, PHOENIX, AZ 85033-4623
(602) 764-2047
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AZ
Other
Enumeration date
04/09/2007
Last updated
07/26/2007
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