Doctor Name: | KRISTIN M WAGNER |
NPI Number: | 1457654808 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., L.P.C. |
License Number: | NLC.0103656 |
Business Practice Address: | 1461 Hickory Ct Erie, CO - 805167986 |
Business Phone Number: | 3035041037 |
Business Fax Number: | |
Mailing Address: | 1461 Hickory Ct, ERIE |
State: | CO |
Postal Code: | 805167986 |
Phone Number: | 3038822755 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2010 |
NPI Last Update Date: | 07/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | NLC.0103656 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |