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Mr. Ethan Williams Wagner
Mental Health Counselor in Chico, California
NPI 1316681398

Ethan Williams Wagner is a Mental Health Counselor based in Chico, CA and is specialized in Mental Health. Ethan Williams Wagner practices in Chico, CA. The NPI Number for Ethan Williams Wagner is 1316681398 and holds a License No. (California).

The current practice location address for Ethan Williams Wagner is 592 Rio Lindo Ave, Chico, CA and can be reached out via phone at 530-891-2775.

Location: 592 Rio Lindo Ave, Chico, CA, 95926-1817
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316681398
Provider Name
Ethan Williams Wagner
Credential
Provider Entity Type
Individual
Gender
Male
Address
592 Rio Lindo Ave, Chico, CA, 95926-1817
Phone Number
530-891-2775
Fax Number
Provider Enumeration Date
04/25/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
592 Rio Lindo Ave
City
Chico
State
California
Zip
95926-1817
Phone Number
530-891-2775
Fax Number
person
Provider Business Mailing Address Details
Address
592 Rio Lindo Ave
City
Chico
State
California
Zip
95926-1817
Phone Number
530-891-2775
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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