Search › Georgia › 101YP2500X
Matthew Wagner, LPC, CAADC
NPI 1053749168 · on the registry since 2013 · sole proprietor
Practice
- Address
- 545 N Mcdonough St Ste 212
Decatur, GA 30030 - Phone
- (770) 766-8128
Registry record
- Primary taxonomy
- 101YP2500X
101YP2500X
- Also registered as
- 101YA0400X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-11-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia