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1730629361
JEAN MARIE WAGNER
LAKEVILLE, MN
NPI
1730629361
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: MN 3028)
Enumeration Date
2017-03-01
Last Update Date
2017-03-01
Business Address
JEAN MARIE WAGNER LMFT
7580 160TH ST W
LAKEVILLE, MN 55044-8348
Phone number: 952-564-6276
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Mailing Address
JEAN MARIE WAGNER LMFT
16569 INTERLACHEN BLVD
LAKEVILLE, MN 55044-4601
Phone number: 612-414-9544
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