Brandy L Wagner

NPI #1023668126 in O Fallon, Illinois

Provider Information

NPI Number
1023668126
Entity Type
Individual
Name
Brandy L Wagner
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Behavior Technician
Enumeration Date
Sep 19, 2019
Last Updated
Sep 19, 2019

Practice Location

Address
634 N MAIN ST STE 4
ZIP Code
62269-3746
Phone
(618) 726-5870

Specialties & Taxonomy Codes

Specialty
Behavior Technician

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