Individual
KRISTIN M WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.C., N.C.C.
Contact information
Practice address
1650 38TH ST STE 100E, BOULDER, CO 80301-2624
(720) 257-9416
Mailing address
11210 FLATIRON DR, LAFAYETTE, CO 80026-9618
(303) 882-2755
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0012533
CO
Other
Enumeration date
12/07/2010
Last updated
01/19/2022
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