Individual
MS. ALEXANDRA MARIAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11301 WILSHIRE BLVD, BLDG 500, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
11301 WILSHIRE BLVD BLDG 500, LOS ANGELES, CA 90073-1003
(310) 478-3711
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
21954
CA
1041C0700X
Clinical Social Worker
Primary
28162
CA
Other
Enumeration date
03/07/2007
Last updated
03/14/2024
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