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1770502338
DIANE MARIE WAGNER
GAINESVILLE, FL
NPI
1770502338
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IA 01216)
Enumeration Date
2006-07-18
Last Update Date
2007-07-08
Business Address
Ms. DIANE MARIE WAGNER lisw
1601 SW ARCHER RD
GAINESVILLE, FL 32608
Phone number: 352-376-1611
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Mailing Address
Ms. DIANE MARIE WAGNER lisw
340 SW 62ND BLVD #3
GAINESVILLE, FL 32607
Phone number: 352-331-0385
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