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Individual
KAREN R WAGNER
Active
Individual
KAREN R WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D, BCBA-D, PHD
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH7979
FL
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019422900
—
FL
Enumeration date
10/22/2008
Last updated
09/09/2021
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