Individual
MRS. TIA J WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
317 S NORTON ST, MARION, IN 46952-3296
(765) 664-0101
(765) 668-8391
Mailing address
317 S NORTON ST, MARION, IN 46952-3296
(765) 664-0101
(765) 668-8391
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
28201834A
IN
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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