Individual
DANIELLE BROOKE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
831 S BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4385
(919) 300-4315
(919) 205-1512
Mailing address
831 S BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4385
(919) 300-4315
(919) 205-1512
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A20450
NC
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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