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Individual

STEPHANIE S WAGENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
508 GREGORY ST, SCOTTSBORO, AL 35768-4239
(256) 259-1774
(256) 259-0761
Mailing address
2721 COUNTY ROAD 151, HENAGAR, AL 35978-6449
(256) 451-6089

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51535932
BCBS
AL
Enumeration date
08/31/2006
Last updated
07/08/2007
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