National Provider Identifier
Kyle Wagner
Kyle Wagner is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Lyons, NY and a listed phone number of (315) 946-5722.
Profile Overview
- NPI
- 1083446850
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- August 19, 2024
- Last Updated
- August 19, 2024
Practice Location
- 1519 Nye RD
- Lyons, NY 14489-9133
Phone: (315) 946-5722
Specialties
- Mental Health Counselor (101YM0800X)
Full Record
- NPI
- 1083446850
- Entity Type
- Individual
- Last Name
- Wagner
- First Name
- Kyle
- Mailing Street Address
- 1519 Nye RD
- Mailing City
- Lyons
- Mailing State
- NY
- Mailing ZIP Code
- 14489-9133
- Mailing Country
- US
- Practice Street Address
- 1519 Nye RD
- Practice City
- Lyons
- Practice State
- NY
- Practice ZIP Code
- 14489-9133
- Practice Country
- US
- Practice Phone
- (315) 946-5722
- Enumeration Date
- August 19, 2024
- Last Updated
- August 19, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- August 19, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X)