Organization
ACTIVE ACCURATE ACTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WAGNER LPC (DIRECTOR)
(405) 606-8886
Entity
Organization
Contact information
Practice address
1330 N CLASSEN BLVD, STU 104, OKLAHOMA CITY, OK 73106-6835
(405) 606-8886
Mailing address
1330 N CLASSEN BLVD, STU 104, OKLAHOMA CITY, OK 73106-6835
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
OK
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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