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1467271122
TERRA WAGNER
IRVING, TX
NPI
1467271122
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: TX 69159)
Enumeration Date
2024-10-08
Last Update Date
2024-10-08
Business Address
DR. TERRA WAGNER PHD, LPC-S
7301 STATE HIGHWAY 161 STE 220
IRVING, TX 75039-2827
Phone number: 682-253-2510
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Mailing Address
DR. TERRA WAGNER PHD, LPC-S
1000 LAKE CAROLYN PKWY APT 4109
IRVING, TX 75039-4824
Phone number: 979-224-0310
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