Individual
JANA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
520 N WALLACE AVE, BOZEMAN, MT 59715-3758
(406) 939-4000
Mailing address
520 N WALLACE AVE, BOZEMAN, MT 59715-3758
(406) 939-4000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39656
MT
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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