Individual
CARLIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 S POTOMAC ST STE 104A, AURORA, CO 80012-4527
(303) 282-2654
Mailing address
1330 S POTOMAC ST STE 104A, AURORA, CO 80012-4527
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12108
CO
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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