Individual
ANNE SUSAN WAGONER-FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW
Contact information
Practice address
2600 YALE BLVD SE, ALBUQUERQUE, NM 87106-4217
(505) 994-7999
(505) 994-7975
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C008083
NC
1041C0700X
Clinical Social Worker
Primary
I-08810
NM
Other
Enumeration date
07/18/2011
Last updated
11/07/2014
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