JONATHAN STEWART WAGNER

NAMPA, ID
NPI1679144836
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: TN  4117)
Enumeration Date2021-07-08
Last Update Date2021-07-08
Business Address
Mr. JONATHAN STEWART WAGNER LPC-MHSP, NCC
2141 W MOOSE CREEK DR
NAMPA, ID 83686-5185
Phone number: 615-426-7352
Mailing Address
Mr. JONATHAN STEWART WAGNER LPC-MHSP, NCC
2141 W MOOSE CREEK DR
NAMPA, ID 83686-5185
Phone number: 615-426-7352
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