Individual
DR. NATHANIEL JACOB WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LMHC
Contact information
Practice address
8256 S CHEROKEE ST, TERRE HAUTE, IN 47802-5014
(812) 370-0370
Mailing address
8256 S CHEROKEE ST, TERRE HAUTE, IN 47802-5014
(812) 370-0370
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39003306A
IN
101YM0800X
Mental Health Counselor
MH12360
FL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2012
Last updated
04/15/2025
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