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1053459362
C. ELISKA WAGNON
LAKE CHARLES, LA
NPI
1053459362
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-02-01
Last Update Date
2007-07-08
Business Address
-- C. ELISKA WAGNON
4105 KIRKMAN ST
LAKE CHARLES, LA 70607-4603
Phone number: 337-475-8022
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Mailing Address
-- C. ELISKA WAGNON
1765 N CLAIBORNE ST
SULPHUR, LA 70663-1154
Phone number: 337-475-8719
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