Individual
MR. STEVEN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5210 E PIMA ST STE 105, TUCSON, AZ 85712-3693
(520) 629-9166
(520) 795-3575
Mailing address
5210 E PIMA ST STE 105, TUCSON, AZ 85712-3693
(520) 629-9166
(520) 795-3575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-2967
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
734732
—
AZ
Enumeration date
01/26/2007
Last updated
07/08/2007
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