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1609418631
ALLISON JADE WAGNER
FREDERICK, MD
NPI
1609418631
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MD LGP9945)
Enumeration Date
2019-10-10
Last Update Date
2019-10-10
Business Address
ALLISON JADE WAGNER LGPC
124 N COURT ST
FREDERICK, MD 21701-6614
Phone number: 301-304-7108
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Mailing Address
ALLISON JADE WAGNER LGPC
222 S RALEIGH ST
MARTINSBURG, WV 25401-2637
Phone number: 304-671-5109
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