Individual
SUSAN FRANCIS WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7511 SAINT ANDREWS RD, SUITE 3, IRMO, SC 29063-2894
(803) 240-5448
(803) 407-3919
Mailing address
114 GLEN RIDGE CT, IRMO, SC 29063-8494
(803) 240-5448
(803) 407-3919
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5206
SC
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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