Candice Brooke Wagner

NPI #1063029908 in Wilmington, North Carolina

Provider Information

NPI Number: 1063029908
Entity Type: Individual
Name: Candice Brooke Wagner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Sep 24, 2020
Last Updated: Sep 24, 2020

Practice Location

Address: 705 S KERR AVE
City: Wilmington
State: North Carolina
ZIP Code: 28403-8425
Phone: (910) 782-3499

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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