Wagstrom, Nicole L

Wagstrom, Nicole L is an individual health care provider with primary practice located at 2000 Red Robin Dr N , Xenia OH 45385-9915. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wagstrom, Nicole L can be contacted via phone (937) 718-3317.

Contact Information

Primary practice address
2000 Red Robin Dr N Xenia OH 45385-9915
Phone: (937) 718-3317
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 8377 Ohio

Profile Details

NPI number 1790814937
LBN Legal business name Wagstrom, Nicole L
Credentials PCC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2007
Last updated Jun 11th, 2026 - about 4 months 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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