Organization
AMY WAGNER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY D WAGNER MFT (OWNER)
(404) 713-7313
Entity
Organization
Contact information
Practice address
346 KRAMER ST, CARROLLTON, GA 30117-3708
(404) 713-7313
Mailing address
346 KRAMER ST, CARROLLTON, GA 30117-3708
(404) 713-7313
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
09/28/2020
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