| Doctor Name: | MS. MARGI LYNN WAGNER-FARLEY |
| NPI Number: | 1659563096 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 3120 State St Ste A East Saint Louis, IL - 622052204 |
| Business Phone Number: | 6188750673 |
| Business Fax Number: | 6188750861 |
| Mailing Address: | 3120 State St Ste A, EAST SAINT LOUIS |
| State: | IL |
| Postal Code: | 622052204 |
| Phone Number: | 6188750673 |
| Fax Number: | 6188750861 |
| NPI Enumeration Date: | 08/09/2007 |
| NPI Last Update Date: | 08/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |