Individual
MRS. ALYSSA NICOLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 W CLINTON AVE, FRESNO, CA 93705-4206
(559) 255-9117
Mailing address
2550 W CLINTON AVE UNIT 128, FRESNO, CA 93705-4227
(559) 225-9117
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23143191
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
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Other
Enumeration date
01/25/2021
Last updated
05/10/2024
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