Individual
HANNAH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1128 NW HARRIMAN ST, BEND, OR 97703-1947
(541) 322-7500
(541) 322-7565
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7752
(541) 322-7500
(541) 322-7565
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/30/2014
Last updated
08/02/2021
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