Individual
DR. DENISE LOUISE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, LCSW
Contact information
Practice address
2055 CORTABELLA, LAS CRUCES, NM 88005-8233
(575) 545-3294
(505) 672-7769
Mailing address
320 10TH ST, SUITE 201, SANTA ROSA, CA 95401-5291
(707) 527-6000
(707) 527-6111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS17251
CA
Other
Enumeration date
06/26/2014
Last updated
10/20/2021
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