NICOLE WAGNER

GRASS VALLEY, CA
NPI1154759033
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date2013-10-31
Last Update Date2013-10-31
Business Address
-- NICOLE WAGNER
714 W MAIN ST
GRASS VALLEY, CA 95945
Phone number: 530-477-9800
Mailing Address
-- NICOLE WAGNER
714 W. MAIN ST
GRASS VALLEY, CA 95945
Phone number: 530-477-9800
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