Individual
MS. AMY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2272 95TH ST, UNIT 305, NAPERVILLE, IL 60564-8942
(630) 753-9800
Mailing address
2272 95TH ST, UNIT 305, NAPERVILLE, IL 60564-8942
(630) 753-9800
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178007525
IL
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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