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1598088973
TARA JO WAGNER
EVANSVILLE, IN
NPI
1598088973
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: IN 34007711A)
Enumeration Date
2010-03-12
Last Update Date
2022-03-29
Business Address
MS. TARA JO WAGNER LCSW
5905 BERRY LN
EVANSVILLE, IN 47710-4377
Phone number: 812-205-3787
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Mailing Address
MS. TARA JO WAGNER LCSW
5905 BERRY LN
EVANSVILLE, IN 47710-4377
Phone number: 812-205-3787
Copy
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