Individual
DANIELLE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
628 FIELDCREST DR, DOVER, DE 19904-1089
(302) 381-0357
Mailing address
628 FIELDCREST DR, DOVER, DE 19904-1089
(302) 381-0357
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
64965
DE
Other
Enumeration date
11/03/2014
Last updated
11/03/2014
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