Individual
DONNA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30211 AVENIDA DE LAS BANDERA, RANCHO SANTA MARGARITA, CA 92688-2147
(949) 939-0279
Mailing address
50 GINGHAM ST, TRABUCO CANYON, CA 92679-5340
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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