| NPI | 1013155571 |
|---|---|
| Former Name | LAURA ANN WAGENMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09931689) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2025-04-29 |