Individual
TANYA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
14502 GREENVIEW DR STE 550, LAUREL, MD 20708-3287
(301) 825-1982
(443) 279-2793
Mailing address
14502 GREENVIEW DR STE 550, LAUREL, MD 20708-3287
(301) 825-1982
(443) 279-2793
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
16413
MD
1041C0700X
Clinical Social Worker
16413
MD
1041C0700X
Clinical Social Worker
LC50079970
DC
Other
Enumeration date
05/17/2011
Last updated
08/12/2024
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