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1073077210
GINNA THERESE WAGNER
BALTIMORE, MD
NPI
1073077210
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MD 16987)
Enumeration Date
2019-01-22
Last Update Date
2019-01-22
Business Address
GINNA THERESE WAGNER LCSW-C
1118 LIGHT ST STE 200
BALTIMORE, MD 21230-4152
Phone number: 667-600-2870
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Mailing Address
GINNA THERESE WAGNER LCSW-C
1118 LIGHT ST STE 200
BALTIMORE, MD 21230-4152
Phone number: 667-600-2870
Copy
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