Individual
TONYA JEAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 HOSPITAL DR, MORRILTON, AR 72110-4510
(501) 354-1561
Mailing address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 967-5570
(479) 890-5364
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/12/2014
Last updated
07/21/2022
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