Individual provider · Type 1 NPI

Anne Bacon Wagstaff, LPC

Professional Counselor · Coeur D Alene, ID

NPI number 1962572230 Active

Practice location

7905 N Meadowlark Way, Suite C
Coeur D Alene, ID 83815-5041

Call (208) 762-3979 Map

Fax (208) 762-4419

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLPC-779 (ID)

Professional Counselor: Definition to come...

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About NPI 1962572230

Anne Bacon Wagstaff, LPC's National Provider Identifier is 1962572230, issued on Nov 8, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Coeur D Alene, ID. The record was last updated on Jul 8, 2007.