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1629220801
SUSAN D. WAGNER
SANTA ROSA, CA
NPI
1629220801
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFC33511)
Enumeration Date
2008-10-19
Last Update Date
2008-10-19
Business Address
SUSAN D. WAGNER MFT
1549 PACIFIC AVE
SANTA ROSA, CA 95404-3507
Phone number: 707-545-7706
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Mailing Address
SUSAN D. WAGNER MFT
1549 PACIFIC AVE
SANTA ROSA, CA 95404-3507
Phone number: 707-545-7706
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