LISA FAE WAGNER

AGOURA HILLS, CA
NPI1659963502
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CA  40867)
Enumeration Date2021-02-10
Last Update Date2021-02-10
Business Address
LISA FAE WAGNER
29532 BERTRAND DR
AGOURA HILLS, CA 91301-4100
Phone number: 310-480-1719
Mailing Address
LISA FAE WAGNER
29532 BERTRAND DR
AGOURA HILLS, CA 91301-4100
Phone number: 310-480-1719