| NPI | 1407103765 |
|---|---|
| Former Name | JULIE ANNE WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E.1100273) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1100273) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2021-12-28 |