Individual
JENNIFER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAMFT
Contact information
Practice address
2345 S ALMA SCHOOL RD STE 105, MESA, AZ 85210-4013
(602) 360-7180
Mailing address
4349 E BANNOCK ST, PHOENIX, AZ 85044-3954
(480) 360-7180
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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