Individual
MS. SUSAN BANDLER WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
23 WEST STREET, NEWFANE, VT 05345
(802) 365-9115
Mailing address
PO BOX 344, NEWFANE, VT 05345-0344
(802) 365-9115
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000330
VT
Other
Enumeration date
03/20/2007
Last updated
07/31/2014
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