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Individual

CASEY WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
18510 MN-371, SUITE A, BRAINERD, MN 56401
(218) 537-8680
Mailing address
18510 MN-371, SUITE A, BRAINERD, MN 56401
(218) 269-2524

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24443
MN

Other

Enumeration date
04/16/2018
Last updated
01/22/2024
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