Wagner, Jonathan Eric

Wagner, Jonathan Eric is an sole proprietor health care provider with primary practice located at 320 Annapolis St E , West St Paul MN 55118-1604. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Wagner, Jonathan Eric can be contacted via phone (651) 210-9549.

Contact Information

Primary practice address
320 Annapolis St E West St Paul MN 55118-1604
Phone: (651) 210-9549
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 02291 Minnesota

Profile Details

NPI number 1063006724
LBN Legal business name Wagner, Jonathan Eric
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2021
Last updated Feb 23rd, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063006724 NPPES
Minnesota Other 02291 STATE OF MINNESOTA

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