Wagner, Leslie Ann
Wagner, Leslie Ann is an sole proprietor health care provider with primary practice located at 533 Saint Clair St , Grosse Pointe MI 48230-1503. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Wagner, Leslie Ann can be contacted via phone (313) 978-7792.Contact Information
Primary practice address
533 Saint Clair St
Grosse Pointe MI 48230-1503
Phone: (313) 978-7792
Fax: (313) 936-1084
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 6301012459 | Michigan |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301012459 | Michigan |
Profile Details
| NPI number | 1013033398 |
|---|---|
| LBN Legal business name | Wagner, Leslie Ann |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 21st, 2007 |
| Last updated | May 23rd, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013033398 | NPPES |
| Other | 1013033398 | NPPES |
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