Individual provider · Type 1 NPI

Lisa Fae Wagner

Mental Health Counselor · Agoura Hills, CA

NPI number 1659963502 Active

Practice location

29532 Bertrand Dr
Agoura Hills, CA 91301-4100

Call (310) 480-1719 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X40867 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1659963502

Lisa Fae Wagner's National Provider Identifier is 1659963502, issued on Feb 10, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Agoura Hills, CA. The record was last updated on Feb 10, 2021.