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Individual

CHRISTINE WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
6714 KELLY ST, PITTSBURGH, PA 15208-1717
(412) 864-5323
(412) 361-4791
Mailing address
6714 KELLY ST, PITTSBURGH, PA 15208-1717
(412) 864-5323
(412) 361-4791

Taxonomy

Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
261QM2800X
PA

Other

Enumeration date
03/18/2015
Last updated
03/18/2015
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