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Organization
THE AUTISM GROUP, INC.
Active
Organization
THE AUTISM GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE E. WAGNER M.A. (OWNER/CEO)
(858) 689-2027
Entity
Organization
Contact information
Practice address
9466 BLACK MOUNTAIN RD, SUITE 100, SAN DIEGO, CA 92126-4550
(858) 689-2027
(858) 689-2027
Mailing address
9466 BLACK MOUNTAIN RD, SUITE 100, SAN DIEGO, CA 92126-4550
(858) 689-2027
(858) 689-2027
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
5056
CA
174400000X
Specialist
Primary
6687
CA
Other
Enumeration date
07/14/2011
Last updated
08/12/2011
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