DR. Ivy Christine Wagner, DBH, LCSW

NPI #1346754702 in Bandon, Oregon

Provider Information

NPI Number: 1346754702
Entity Type: Individual
Name: DR. Ivy Christine Wagner, DBH, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: DBH, LCSW
Enumeration Date: Nov 21, 2017
Last Updated: Aug 16, 2024

Practice Location

Address: 780 2ND ST SE STE 10
City: Bandon
State: Oregon
ZIP Code: 97411-8354
Phone: (541) 329-2144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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