Individual
WILLIAM RICHARD WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.W., A.P.S.W.
Contact information
Practice address
420 7TH ST, RACINE, WI 53403-1222
(262) 634-2391
(262) 634-5342
Mailing address
420 7TH ST, RACINE, WI 53403-1222
(262) 634-2391
(262) 634-5342
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
127915-121
WI
1041C0700X
Clinical Social Worker
127915-121
WI
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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