Individual provider · Type 1 NPI

Breanna Wagner

Addiction (Substance Use Disorder) Counselor · Eden Prairie, MN

NPI number 1083120984 Active

Practice location

11010 Prairie Lakes Dr Ste 350
Eden Prairie, MN 55344-3801

Call (952) 746-2522 Map

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1083120984

Breanna Wagner's National Provider Identifier is 1083120984, issued on Dec 14, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Eden Prairie, MN. The record was last updated on Dec 14, 2017.