Individual
ANGELA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
576 OLIVE ST STE 307, EUGENE, OR 97401-2995
(541) 912-5913
Mailing address
PO BOX 854, EUGENE, OR 97440-0854
(458) 317-7777
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
OR
1041C0700X
Clinical Social Worker
Primary
L11945
OR
172V00000X
Community Health Worker
—
—
Other
Enumeration date
09/22/2017
Last updated
11/27/2024
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