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 |