Individual
MRS. BEVERLY ANNE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
161 LANDMARK DR, TAYLORS, SC 29687-2819
(864) 244-0154
(864) 609-5003
Mailing address
161 LANDMARK DR, TAYLORS, SC 29687-2819
(864) 244-0154
(864) 609-5003
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5028
SC
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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