Individual provider · Type 1 NPI
Randall L. Wagner, LPC
Professional Counselor · Madison, WI
NPI number
1063558211
Active
Practice location
1821 S Stoughton Rd
Madison, WI 53716-2257
Fax (608) 260-6376
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 3203-125 (WI) |
Professional Counselor: Definition to come...
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About NPI 1063558211
Randall L. Wagner, LPC's National Provider Identifier is 1063558211, issued on Jan 29, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Madison, WI. The record was last updated on Dec 15, 2020.