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1780854059
THEODORE LEE WAGENER
OKLAHOMA CITY, OK
NPI
1780854059
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-03-03
Last Update Date
2008-03-03
Business Address
Mr. THEODORE LEE WAGENER M.S.
940 NE 13TH ST
OKLAHOMA CITY, OK 73104-5008
Phone number: 405-271-4407
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Mailing Address
Mr. THEODORE LEE WAGENER M.S.
940 NE 13TH ST
OKLAHOMA CITY, OK 73104-5008
Phone number:
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