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Individual

DR. KRISTY WAGNER LASTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3900 LAKELAND DR STE 504, FLOWOOD, MS 39232-8854
(769) 208-5120
Mailing address
3900 LAKELAND DR STE 504, FLOWOOD, MS 39232-8854
(769) 208-5120

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2675
MS

Other

Enumeration date
07/16/2021
Last updated
07/16/2021
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