Individual
LINDA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5862 CROMO DR, SUITE 145, EL PASO, TX 79912-5551
(915) 585-9760
(915) 842-0054
Mailing address
5862 CROMO DR, SUITE 145, EL PASO, TX 79912-5551
(915) 585-9760
(915) 842-0054
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12443
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82773L
BCBS
TX
Enumeration date
10/04/2005
Last updated
07/08/2007
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