Individual
MELISA CATHERINE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6862 RAILROAD RD, HARRISON, MI 48625-9067
(989) 313-3039
Mailing address
6862 RAILROAD RD, HARRISON, MI 48625-9067
(989) 313-3039
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035840738
—
MI
Enumeration date
01/16/2023
Last updated
01/16/2023
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