Individual
NATASHA MARIE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5909 W AUTUMN VISTA WAY, FLORENCE, AZ 85132-1294
(480) 540-1099
Mailing address
5909 W AUTUMN VISTA WAY, FLORENCE, AZ 85132-1294
(480) 540-1099
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401008764
MI
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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