Individual
KELLY MCMAHON WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
4701 GREENSPRING AVE, BALTIMORE, MD 21209-4704
(443) 642-2027
Mailing address
4701 GREENSPRING AVE, BALTIMORE, MD 21209-4704
(443) 642-2027
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
08329
MD
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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