Jordan Wagner

NPI #1982495479 in La Salle, Colorado

Provider Information

NPI Number: 1982495479
Entity Type: Individual
Name: Jordan Wagner
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: May 14, 2025
Last Updated: May 14, 2025

Practice Location

Address: 112 N 3RD ST
City: La Salle
State: Colorado
ZIP Code: 80645-3200
Phone: (970) 415-6592

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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