Individual provider · Type 1 NPI
Kathleen Ann Wagner, MA, LPC
Professional Counselor · Fayetteville, GA
NPI number
1982969754
Active
Practice location
145 Emerald Ln
Fayetteville, GA 30214-4234
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC006769 (GA) |
Professional Counselor: Definition to come...
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About NPI 1982969754
Kathleen Ann Wagner, MA, LPC's National Provider Identifier is 1982969754, issued on Jul 9, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Fayetteville, GA. The record was last updated on May 14, 2020.