Individual
BETTY LOUISE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1028 BIRMLEY ESTATES DR, TRAVERSE CITY, MI 49696-8838
(231) 492-6529
Mailing address
1028 BIRMLEY ESTATES DR, TRAVERSE CITY, MI 49696-8838
(231) 492-6529
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801081590
MI
1041C0700X
Clinical Social Worker
6801081590
MI
1041C0700X
Clinical Social Worker
L7525
OR
Other
Enumeration date
01/22/2007
Last updated
06/12/2026
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