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Jonathan Eric Wagner, MA
Mental Health Counselor in West St Paul, Minnesota
NPI 1063006724

Jonathan Eric Wagner is a Mental Health Counselor based in West St Paul, MN and is specialized in Mental Health. Jonathan Eric Wagner practices in West St Paul, MN and has the professional credentials of MA. The NPI Number for Jonathan Eric Wagner is 1063006724 and holds a License No. 02291 (Minnesota).

The current practice location address for Jonathan Eric Wagner is 320 Annapolis St E, West St Paul, MN and can be reached out via phone at 651-210-9549.

Location: 320 Annapolis St E, West St Paul, MN, 55118-1604
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063006724
Provider Name
Jonathan Eric Wagner
Credential
MA
Provider Entity Type
Individual
Gender
Male
Address
320 Annapolis St E, West St Paul, MN, 55118-1604
Phone Number
651-210-9549
Fax Number
Provider Enumeration Date
02/23/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02291 01 MN STATE OF MINNESOTA
institution
Provider Business Practice Location Address Details
Address
320 Annapolis St E
City
West St Paul
State
Minnesota
Zip
55118-1604
Phone Number
651-210-9549
Fax Number
person
Provider Business Mailing Address Details
Address
320 Annapolis St E
City
West St Paul
State
Minnesota
Zip
55118-1604
Phone Number
651-210-9549
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
02291 (Minnesota)
Definition
Definition to come...
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