Individual
KATHERINE ANNA VAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
50 JOY DR, SOUTH BURLINGTON, VT 05403-6561
(802) 864-7467
Mailing address
50 JOY DR, SOUTH BURLINGTON, VT 05403-6561
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0115736
VT
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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