Individual
NICOLE MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
3240 NORTHWEST AVE, BELLINGHAM, WA 98225-1318
(360) 450-5025
(360) 734-3270
Mailing address
3240 NORTHWEST AVE, BELLINGHAM, WA 98225-1318
(360) 450-5025
(360) 734-3270
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61421072
WA
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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