MS. MICHELLE DEAN WAGNER M.S.L.P.C. B.C.P.C NPI 1528265956

NPI Information

NPI: 1528265956
Provider Name: MS. MICHELLE DEAN WAGNER, M.S.,L.P.C., B.C.P.C
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
833 BROADWAY ST
SUITE 103
CAPE GIRARDEAU, MO
ZIP 63701
Phone: (573) 332-7889
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MS. Michelle Dean Wagner, M.S.,L.P.C., B.C.P.C is a professional counselor in Cape Girardeau, MO. MS. Michelle Dean Wagner, M.S.,L.P.C., B.C.P.C NPI is 1528265956. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

833 BROADWAY ST
SUITE 103
CAPE GIRARDEAU, MO
ZIP 63701-515
Phone: (573) 332-7889
Fax: (573) 332-7889

The enumeration date for this NPI number is 6/29/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	2001012922	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	495017337	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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