Individual
MS. ALLISON VICTORIA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
79 LASALLE PATH, QUINCY, FL 32351-5286
(850) 523-3333
Mailing address
1977 MAYMEADOW LN, TALLAHASSEE, FL 32303-3581
(229) 834-4161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW23552
FL
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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