Provider Demographics
NPI:1285779587
Name:WAGNER, RACHEL MARIE (MSED, LPC, CAADC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MARIE
Last Name:WAGNER
Suffix:
Gender:F
Credentials:MSED, LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 OHIO RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-1454
Mailing Address - Country:US
Mailing Address - Phone:412-766-4030
Mailing Address - Fax:412-732-7409
Practice Address - Street 1:8235 OHIO RIVER BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-1454
Practice Address - Country:US
Practice Address - Phone:412-766-4030
Practice Address - Fax:412-732-7409
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004422101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor