Individual
MRS. LYNNETTE YVONNE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
18101 HARTLEY DR, BRAINERD, MN 56401-7915
(218) 828-4611
(218) 828-4611
Mailing address
18101 HARTLEY DR, BRAINERD, MN 56401-7915
(218) 828-4611
(218) 828-4611
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/20/2008
Last updated
10/04/2017
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