Individual
MS. TIFFANY WYNN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
602 E ACADEMY ST, 205, FUQUAY VARINA, NC 27526-2302
(919) 412-7321
Mailing address
644 AIKEN PKWY, FUQUAY VARINA, NC 27526-2064
(919) 412-7321
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
820
NC
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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