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Individual

MS. HEIDI RENEE' WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATR-BC, LSW

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
S-0018147
OH
221700000X
Art Therapist
Primary
94-160,CERTIFICATION
OH

Other

Enumeration date
05/23/2007
Last updated
09/11/2025
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