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Individual

ANNE S WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2622 PIONEER AVE, CHEYENNE, WY 82001-3024
(307) 632-2240
(307) 637-2899
Mailing address
2622 PIONEER AVE, CHEYENNE, WY 82001-3402
(307) 632-2240
(307) 637-2899

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
072
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
286867
VALUE OPTIONS
WY
01
303435
BS OF WY
WY
01
W10059
MEDICARE GROUP PIN
WY
Enumeration date
01/08/2007
Last updated
04/17/2008
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