Individual
MRS. JANE ELLEN WAGNER-GARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
118 W PINE ST, FARMINGTON, MO 63640-1403
(573) 701-5902
Mailing address
118 WEST PINE, FARMINGTON, MO 63640-1614
(573) 701-5902
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002053
MO
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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