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1114333549
BRIAN WAGNER
SPARTANBURG, SC
NPI
1114333549
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-07-07
Last Update Date
2014-07-07
Business Address
-- BRIAN WAGNER
250 DEWEY AVE
SPARTANBURG, SC 29303-3009
Phone number: 864-585-0366
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Mailing Address
-- BRIAN WAGNER
250 DEWEY AVE
SPARTANBURG, SC 29303-3009
Phone number: 864-585-0366
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