Individual
MADISON GABRIELLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, NCC
Contact information
Practice address
1820 CENTRAL AVE, ESTHERVILLE, IA 51334-2409
(800) 592-0180
Mailing address
PO BOX 36, ESTHERVILLE, IA 51334-0036
(800) 592-0180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
093041
IA
Other
Enumeration date
09/04/2020
Last updated
02/18/2021
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