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Mr. Robert W Wagner, LPC
Professional Counselor in Tyrone, Georgia
NPI 1457309387

Robert W Wagner is a Professional Counselor based in Tyrone, GA and is specialized in Professional. Robert W Wagner practices in Tyrone, GA and has the professional credentials of LPC. The NPI Number for Robert W Wagner is 1457309387 and holds a License No. 003153 (Georgia).

The current practice location address for Robert W Wagner is 105 Greencastle Rd, Tyrone, GA and can be reached out via phone at 770-486-1011.

Location: 105 Greencastle Rd, Tyrone, GA, 30290-2937
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457309387
Provider Name
Robert W Wagner
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
105 Greencastle Rd, Tyrone, GA, 30290-2937
Phone Number
770-486-1011
Fax Number
Provider Enumeration Date
05/04/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
105 Greencastle Rd
City
Tyrone
State
Georgia
Zip
30290-2937
Phone Number
770-486-1011
Fax Number
person
Provider Business Mailing Address Details
Address
105 Greencastle Rd
City
Tyrone
State
Georgia
Zip
30290-2937
Phone Number
770-486-1011
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...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
003153 (Georgia)
Definition
Definition to come...
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