Individual
CASEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, SAC-IT
Contact information
Practice address
5005 UNIVERSITY AVE STE 100, MADISON, WI 53705-5400
(608) 233-2100
Mailing address
5005 UNIVERSITY AVE STE 100, MADISON, WI 53705-5400
(608) 233-2100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
WI
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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