Wagner, Elizabeth

Wagner, Elizabeth is an sole proprietor health care provider with primary practice located at 105 N Fair St , Champaign IL 61821. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Wagner, Elizabeth can be contacted via phone (217) 398-8090.

Contact Information

Primary practice address
105 N Fair St Champaign IL 61821
Phone: (217) 398-8090
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 180.003668 Illinois
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist 221700000X 00-105 North Carolina
Behavioral Health & Social Service Providers / Counselor 101Y00000X 180.003668 Illinois

Profile Details

NPI number 1306062922
LBN Legal business name Wagner, Elizabeth
Credentials LCPC ATR-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 18th, 2007
Last updated Nov 14th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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