Individual
ASHLEIGH ANNE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMHCA
Contact information
Practice address
9150 E 109TH AVE STE 1B, CROWN POINT, IN 46307-7686
(219) 743-1552
Mailing address
11603 RHODE ISLAND PL, CROWN POINT, IN 46307-0136
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88000821A
IN
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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