Patrick Joseph Wagner LCSW

NPI 1053680082 - Social Worker - 1041C0700X

NPI Details
NPI 1053680082
Gender Male
Enumeration Date 12/20/2011
Last Updated 10/24/2014
Entity Type Individual
Active Over 4 years ago
Practice Location
1015 DORSEY LN
LOUISVILLE KY, 40223-2612, US
Phone (502) 245-1576
Fax (502) 245-8973
Business Location
1015 DORSEY LN
LOUISVILLE KY, 40223-2612, US
Phone (502) 245-1576
Fax (502) 245-8973
Toxanomy
Taxonomy Code 1041C0700X
License State Connecticut
License Number 008041
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According to our database, Mr. Patrick Joseph Wagner LCSW NPI is 1053680082, taxonomy code is 1041C0700X and license number is 008041, license state is located at Connecticut. Patrick Joseph Wagner LCSW physically located at 1015 Dorsey Ln, Louisville KY, 40223-2612. NPI Number Patrick Joseph Wagner LCSW has the Individual type.

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1053680082 NPI number is provided on an as is basis without warranty of any kind. 1053680082 is maintained by the National Plan & Provider Enumeration System. The contents of Patrick Joseph Wagner LCSW are for informational purposes only.