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1083777148
DIANE WAGNER
ALBUQUERQUE, NM
NPI
1083777148
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NM I-04793)
Enumeration Date
2006-12-19
Last Update Date
2007-07-08
Business Address
Ms. DIANE WAGNER LISW
5100 2ND ST NW
ALBUQUERQUE, NM 87107-4009
Phone number: 505-761-6600
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Mailing Address
Ms. DIANE WAGNER LISW
5100 2ND ST NW
ALBUQUERQUE, NM 87107-4009
Phone number: 505-761-6600
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