Individual
CHRISTINE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
140 NEWTON ST, FREDONIA, NY 14063-1304
(716) 640-4037
Mailing address
140 NEWTON ST, FREDONIA, NY 14063-1304
(716) 640-4037
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
004701
NY
Other
Enumeration date
12/16/2020
Last updated
03/17/2021
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