MR. Robert W Wagner, LPC

NPI #1457309387 in Tyrone, Georgia

Provider Information

NPI Number: 1457309387
Entity Type: Individual
Name: MR. Robert W Wagner, LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: LPC
Enumeration Date: May 4, 2006
Last Updated: Dec 26, 2007

Practice Location

Address: 105 GREENCASTLE RD
Address 2: SUITE B
City: Tyrone
State: Georgia
ZIP Code: 30290-2937
Phone: (770) 486-1011

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary
Counselor - Professional — Professional	101YP2500X

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