Individual
DEBRA SMITH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
MINNEAPOLIS VAMC-122, ONE VETERANS DRIVE, MINNEAPOLIS, MN 55417
(612) 725-2042
(612) 725-2126
Mailing address
12918 HAMLET AVE, APPLE VALLEY, MN 55124-9730
(952) 454-3433
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14470
MN
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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