person
Mr. Gerald Wagner JR., LADC
Addiction (Substance Use Disorder) Counselor in New London, Connecticut
NPI 1962759084

Gerald Wagner JR. is an Addiction (Substance Use Disorder) Counselor based in New London, CT and is specialized in Addiction (Substance Use Disorder). Gerald Wagner JR. practices in New London, CT and has the professional credentials of LADC. The NPI Number for Gerald Wagner JR. is 1962759084 and holds a License No. 000326 (Connecticut).

The current practice location address for Gerald Wagner JR. is 21 Montauk Ave, New London, CT and can be reached out via phone at 860-271-4715 and via fax at 860-271-4797.

Location: 21 Montauk Ave, New London, CT, 06320-0390
person
Provider Profile Details
NPI Number
1962759084
Provider Name
Gerald Wagner JR.
Credential
LADC
Provider Entity Type
Individual
Gender
Male
Address
21 Montauk Ave, New London, CT, 06320-0390
Phone Number
860-271-4715
Fax Number
860-271-4797
Provider Enumeration Date
08/08/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
21 Montauk Ave
City
State
Zip
06320-4906
Phone Number
860-271-4715
Fax Number
860-271-4797
person
Provider Business Mailing Address Details
Address
21 Montauk Ave
City
State
Zip
06320-4906
Phone Number
860-271-4715
Fax Number
860-271-4797
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
000326 (Connecticut)
Definition
Definition to come...
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