Individual
CHRISTY TAYLOR WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2300 RAMSEY ST, FAYETTEVILLE, NC 28301-3856
(910) 488-2120
(910) 482-5099
Mailing address
7827 AMESBURY RD, FAYETTEVILLE, NC 28311-9364
(910) 482-4669
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
775
NC
1041C0700X
Clinical Social Worker
Primary
C002698
NC
Other
Enumeration date
06/07/2006
Last updated
08/09/2021
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