| NPI | 1558478388 |
|---|---|
| Former Name | ERIN L WAGONER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC16981) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CO 118) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-01-22 |