Individual
ANGELA K WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
410 N DILLARD ST, WINTER GARDEN, FL 34787-2853
(407) 654-5700
Mailing address
410 N DILLARD ST STE 103, WINTER GARDEN, FL 34787-2853
(407) 654-5700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
18750
FL
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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