Individual
CHRISTINA WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
65 THOMAS JOHNSON DR, SUITE A, FREDERICK, MD 21702-4371
(240) 575-9688
Mailing address
65 THOMAS JOHNSON DR, SUITE A, FREDERICK, MD 21702-4371
(240) 575-9688
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC7181
MD
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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