Organization · NPI-2

Anne S Wagner, Lcsw, PC

Social Worker, Clinical · Cheyenne, WY

NPI number1871592592
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1871592592
Entity type
Organization (NPI-2)
Legal business name
Anne S Wagner, Lcsw, PC
Organization subpart
No
Enumeration date
Jul 14, 2005
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical072WYYes

Practice location

2622 Pioneer Ave
Cheyenne, WY 82001-3024

Phone 307-637-7736

Mailing address

2622 Pioneer Ave
Cheyenne, WY 82001-3024

Authorized official

Anne S Wagner
Owner
3076377736

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