Individual
LORINDA WAGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 MEETING STREET RD # C, N CHARLESTON, SC 29405-7715
(843) 308-4690
Mailing address
3601 MEETING STREET RD # C, N CHARLESTON, SC 29405-7715
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190166
—
SC
Enumeration date
06/27/2007
Last updated
07/08/2007
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