Individual
IAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 W PENNSYLVANIA ST, ALLENTOWN, PA 18102-1036
(484) 640-6431
Mailing address
1401 W PENNSYLVANIA ST, ALLENTOWN, PA 18102-1036
(484) 640-6431
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/18/2020
Last updated
11/28/2022
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