| NPI | 1992054928 |
|---|---|
| Former Name | KAREN L WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 4674) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 4674-125) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2023-12-27 |