| Doctor Name: | JOHN F. WAGNER |
| NPI Number: | 1235311275 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW |
| License Number: | I.1925 |
| Business Practice Address: | 30800 Chagrin Blvd Pepper Pike, OH - 441245925 |
| Business Phone Number: | 2165910324 |
| Business Fax Number: | 2165911243 |
| Mailing Address: | 30800 Chagrin Blvd, PEPPER PIKE |
| State: | OH |
| Postal Code: | 441245925 |
| Phone Number: | 2165910324 |
| Fax Number: | 2165911243 |
| NPI Enumeration Date: | 12/01/2007 |
| NPI Last Update Date: | 12/01/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I.1925 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |