Individual
MRS. CASSANDRA A WAGSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
239A OLD NATIONAL RD, OLD WASHINGTION, OH 43768-0094
(740) 489-5571
(740) 489-5004
Mailing address
PO BOX 94, OLD WASHINGTON, OH 43768-0094
(740) 489-5571
(740) 489-5004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
S1500885
OH
Other
Enumeration date
04/27/2018
Last updated
04/27/2018
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