Mr. Ethan Williams Wagner
Mr. Ethan Williams Wagner is a Mental Health Counselor in Chico, California. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
592 Rio Lindo AveChico, CA 95926-1817
Phone: (530) 891-2775
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Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1316681398 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 25, 2022 |
| Last updated in NPPES | April 25, 2022 |
| Certification date | April 25, 2022 |
| Mailing address | 592 Rio Lindo Ave, Chico, CA 95926-1817 |
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Mr. Richard Wadsworth
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Mr. Corey Andrew Walker
592 Rio Lindo Ave, Chico, CA 95926-1817 · (530) 891-2775