Vickie Joan Wagner
Marriage & Family Therapist in Pasadena, CA. Individual provider (NPI-1).
NPI number1982117198
StatusActive
Last updated in NPPESNov 9, 2017
Details
- NPI
- 1982117198
- Entity type
- Individual (NPI-1)
- Name
- Vickie Joan Wagner
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 9, 2017
- Last updated
- Nov 9, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | – | – | Yes |
Practice location
210 S De Lacey Ave Ste 110Pasadena, CA 91105-2074
Phone 626-395-7100
Mailing address
210 S De Lacey Ave Ste 110Pasadena, CA 91105-2074
Phone 626-395-7100
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