Individual
VONDA KARLA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2243 EDDIE WILLIAMS RD, JOHNSON CITY, TN 37601-2872
(423) 928-5627
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3674
TN
247200000X
Other Technician
—
—
Other
Enumeration date
03/05/2008
Last updated
08/10/2016
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