GARY ALLEN WAGENAAR

AUSTIN, MN
NPI1851683049
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  300609)
Enumeration Date2011-05-06
Last Update Date2011-05-06
Business Address
-- GARY ALLEN WAGENAAR MS LADC
1000 1ST DR NW
AUSTIN, MN 55912-2941
Phone number: 507-434-1928
Mailing Address
-- GARY ALLEN WAGENAAR MS LADC
1000 1ST DR NW
AUSTIN, MN 55912-2941
Phone number: 507-434-1928
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