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1982969754
KATHLEEN ANN WAGNER
FAYETTEVILLE, GA
NPI
1982969754
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: GA LPC006769)
Enumeration Date
2012-07-09
Last Update Date
2020-05-14
Business Address
MRS. KATHLEEN ANN WAGNER MA, LPC
145 EMERALD LN
FAYETTEVILLE, GA 30214-4234
Phone number: 678-871-5927
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Mailing Address
MRS. KATHLEEN ANN WAGNER MA, LPC
145 EMERALD LN
FAYETTEVILLE, GA 30214-4234
Phone number: 678-871-5927
Copy
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