Most Relevant Information
Provider Data
| NPI Number: | 1003325416 |
| Provider Name: | PHYLISS WAGNER LPCC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | E.2001993 |
Most Important Dates
| Enumeration Date: | 09/28/2017 |
| Last Updated: | 09/25/2024 |
Provider Practice Location
842 CORPORATE WAY STE 850
WESTLAKE
OH
441451537
Practice Location Phone/Fax
| Phone: | 4402962050 |
| Fax: |
Provider Mailing Location
107 WOODSTOCK DR
AVON LAKE
OH
440121622
Provider Mailing Phone/Fax
| Phone: | 4409894987 |
| Fax: | 4402962050 |