| NPI | 1821317306 |
|---|---|
| Other Name | BEN WAGNER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: CA Aii052430218) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2023-05-15 |