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Individual

MR. STEPHEN CHARLES WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
321 E MAIN ST, SUITE 205, BOZEMAN, MT 59715
(406) 595-2263
Mailing address
321 E MAIN ST, SUITE 205, BOZEMAN, MT 59715
(406) 595-2263
(406) 522-7076

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
93
MT

Other

Enumeration date
07/12/2006
Last updated
07/08/2007
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