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General NPI Number Information
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NPI Number | 1295880177
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Entity Type | Individual
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Provider Name | LOUISE WHELCHEL WAGNER RN,MSN,CS-P
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 205 E MAIN ST
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City | ELKTON
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State | MD
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Zip | 21921-5769
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Country | US
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Telephone | 410-398-9557
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Fax | 410-398-3325
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Provider Business Mailing Address
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Address Line | 100 HOILAND DR
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City | WILMINGTON
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State | DE
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Zip | 19803-3228
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Country | US
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Telephone | 302-764-3731
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Fax | 410-398-3325
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AC000040
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License Number State | MD
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