Individual
VANESSA FUSON WAGSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 E RED RIVER ST, VICTORIA, TX 77901-5236
(361) 575-1117
Mailing address
103 E RED RIVER ST, VICTORIA, TX 77901-5236
(361) 575-1117
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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