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1255906145
JORDAN ELAINE WAGNER
FREDERICK, MD
NPI
1255906145
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: MD LGM810)
Enumeration Date
2021-05-24
Last Update Date
2021-05-24
Business Address
JORDAN ELAINE WAGNER LGMFT
2126 CAISSON RD
FREDERICK, MD 21702-6806
Phone number: 301-473-2197
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Mailing Address
JORDAN ELAINE WAGNER LGMFT
11232 ANGLEBERGER RD
THURMONT, MD 21788-2503
Phone number: 443-605-7203
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