Wagner, Michelle Dean
Wagner, Michelle Dean is an sole proprietor health care provider with primary practice located at 833 Broadway St Suite 103, Cape Girardeau MO 63701-5515. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wagner, Michelle Dean can be contacted via phone (573) 332-7889.Contact Information
Primary practice address
833 Broadway St Suite 103
Cape Girardeau MO 63701-5515
Phone: (573) 332-7889
Fax: (573) 332-7889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 2001012922 | Missouri |
Profile Details
| NPI number | 1528265956 |
|---|---|
| LBN Legal business name | Wagner, Michelle Dean |
| Credentials | M.S.,L.P.C., B.C.P.C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1528265956 | NPPES |
| Missouri | MEDICAID | 495017337 |
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