| Mary L. Wagner Llc | |
|
313 Encino Avenue San Antonio TX 78209 | |
| (210) 821-6464 | |
| Not Available |
| Full Name | Mary L. Wagner Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 313 Encino Avenue, San Antonio, Texas |
| Authorized Official Name and Position | Mary L. Wagner (OWNER) |
| Authorized Official Contact | 2108216464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary L. Wagner Llc 313 Encino Avenue San Antonio TX 78209 Ph: (210) 821-6464 | Mary L. Wagner Llc 313 Encino Avenue San Antonio TX 78209 Ph: (210) 821-6464 |
| NPI Number | 1184957441 |
|---|---|
| Provider Enumeration Date | 09/17/2009 |
| Last Update Date | 02/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184957441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 07873 (Texas) | Primary |
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