person
Jason Fredrick Wagner, APRN,LMHC,MCAP
Psychiatric/Mental Health Nurse Practitioner in Hollywood, Florida
NPI 1720536691

Jason Fredrick Wagner is a Psychiatric/Mental Health Nurse Practitioner based in Weston, FL and is specialized in Psychiatric/Mental Health. Jason Fredrick Wagner practices in Hollywood, FL and has the professional credentials of APRN,LMHC,MCAP. The NPI Number for Jason Fredrick Wagner is 1720536691 and holds a License No. MH8961 (Florida).

The current practice location address for Jason Fredrick Wagner is 111 W Coral Way, Hollywood, FL and can be reached out via phone at 954-964-6338 and via fax at 954-965-1327.

Location: 111 W Coral Way, Hollywood, FL, 33326-1111
person
Provider Profile Details
NPI Number
1720536691
Provider Name
Jason Fredrick Wagner
Credential
APRN,LMHC,MCAP
Provider Entity Type
Individual
Gender
Male
Address
111 W Coral Way, Hollywood, FL, 33326-1111
Phone Number
954-964-6338
Fax Number
954-965-1327
Provider Enumeration Date
09/20/2016
Last Update Date
05/18/2024
institution
Provider Business Practice Location Address Details
Address
111 W Coral Way
City
State
Zip
33021-3860
Phone Number
954-964-6338
Fax Number
954-965-1327
person
Provider Business Mailing Address Details
Address
111 W Coral Way
City
State
Zip
33021-3860
Phone Number
954-964-6338
Fax Number
954-965-1327
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
APRN11004343 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
MH8961 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
MH8961 (Florida)
Definition
Definition to come...
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