Individual
KRISTEN MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
384 PRATT ST, MERIDEN, CT 06450-8627
(203) 235-5767
Mailing address
263 STAMM RD, NEWINGTON, CT 06111-3626
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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