Individual
MR. EDWARD T WAGNER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1831 SWAMP PIKE STE 100, GILBERTSVILLE, PA 19525-8927
(610) 484-0736
Mailing address
2583 CRABAPPLE CT, GILBERTSVILLE, PA 19525-8839
(610) 850-3859
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC012234
PA
Other
Enumeration date
03/09/2020
Last updated
11/29/2024
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