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Benton Wagner
Mental Health Counselor in Hailey, Idaho
NPI 1346668852

Benton Wagner is a Mental Health Counselor based in Fairfield, ID and is specialized in Mental Health. Benton Wagner practices in Hailey, ID. The NPI Number for Benton Wagner is 1346668852 and holds a License No. LCPC-6760 (Idaho).

The current practice location address for Benton Wagner is 418 N River St, Hailey, ID and can be reached out via phone at 612-247-9768.

Location: 418 N River St, Hailey, ID, 83327-0424
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346668852
Provider Name
Benton Wagner
Credential
Provider Entity Type
Individual
Gender
Male
Address
418 N River St, Hailey, ID, 83327-0424
Phone Number
612-247-9768
Fax Number
Provider Enumeration Date
04/01/2014
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
418 N River St
City
Hailey
State
Idaho
Zip
83333-8513
Phone Number
612-247-9768
Fax Number
person
Provider Business Mailing Address Details
Address
418 N River St
City
Hailey
State
Idaho
Zip
83333-8513
Phone Number
612-247-9768
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
LCPC-6760 (Idaho)
Definition
Definition to come...
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