| NPI | 1255478574 |
|---|---|
| Former Name | KARIN WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 593124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11646131) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2009-04-22 |