Individual
CAROL WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2346 S LYNHURST DR, INDIANAPOLIS, IN 46241-8621
(317) 626-0775
Mailing address
PO BOX 421566, INDIANAPOLIS, IN 46242-1566
(317) 626-0775
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001302A
IN
Other
Enumeration date
03/15/2007
Last updated
06/06/2016
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