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1366294829
NATASHA ANNE WAGNER
GRASS VALLEY, CA
NPI
1366294829
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1556440424)
Enumeration Date
2024-04-05
Last Update Date
2024-04-05
Business Address
NATASHA ANNE WAGNER RADT
180 SIERRA COLLEGE DR
GRASS VALLEY, CA 95945-5768
Phone number: 530-273-9541
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Mailing Address
NATASHA ANNE WAGNER RADT
10227 WELSH LN
GRASS VALLEY, CA 95949-9109
Phone number: 530-263-5685
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