Jacqueline Nicole Wagner, MLSW

NPI #1366849473 in Benton Harbor, Michigan

Provider Information

NPI Number: 1366849473
Entity Type: Individual
Name: Jacqueline Nicole Wagner, MLSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: MLSW
Enumeration Date: Dec 4, 2014
Last Updated: Jan 31, 2018

Practice Location

Address: 1613 M 139
City: Benton Harbor
State: Michigan
ZIP Code: 49022-5748
Phone: (269) 934-0716

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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