Individual
MS. DENETTE ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2321 W DAYTON AIRPORT RD, SHELTON, WA 98584-6319
(360) 426-4433
Mailing address
7345 LINDERSON WAY SW, TUMWATER, WA 98501-6504
(360) 725-8213
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW61281864
WA
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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