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1033269329
LAURA J WAGNER
JACKSONVILLE, FL
NPI
1033269329
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: FL SW 8239)
Enumeration Date
2007-01-11
Last Update Date
2007-07-08
Business Address
LAURA J WAGNER LCSW
1100 CESERY BLVD STE 11
JACKSONVILLE, FL 32211-5656
Phone number: 904-745-3070
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Mailing Address
LAURA J WAGNER LCSW
8572 ETHANS GLEN TER
JACKSONVILLE, FL 32256-9069
Phone number: 904-226-7777
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