Taryn Mikelle Wagner

NPI #1457990368 in Okc, Oklahoma

Provider Information

NPI Number: 1457990368
Entity Type: Individual
Name: Taryn Mikelle Wagner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 26, 2019
Last Updated: Dec 26, 2019

Practice Location

Address: 14828 SERENITA AVE
City: Okc
State: Oklahoma
ZIP Code: 73134
Phone: (858) 782-7822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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