Individual
KENDALL TODD CARMAN-WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1012 S 3RD ST, DAYTON, WA 99328-1606
(509) 382-2531
Mailing address
350 EQUESTRIAN WAY, WALLA WALLA, WA 99362-6220
(509) 529-1496
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00000091
WA
1041C0700X
Clinical Social Worker
Primary
LW00005301
WA
Other
Enumeration date
01/11/2007
Last updated
02/15/2024
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