Individual
REBECCA A WAGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
28 PARK AVENUE WEST, SUITE 300, MANSFIELD, OH 44902
(419) 522-5015
(419) 522-5017
Mailing address
28 PARK AVE W, SUITE 300, MANSFIELD, OH 44902-1648
(419) 522-5015
(419) 522-5017
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
140925
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140925
OHIO CHEMICAL DEPENDENCY PROFESSIONALS BOARD
OH
Enumeration date
04/27/2016
Last updated
04/27/2016
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