Individual
DARRIN WAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701003867
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010281547
—
VA
Enumeration date
08/20/2006
Last updated
03/04/2010
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