Individual
AMY M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S., BCABA
Contact information
Practice address
9402 BULLFROG CT, GIBSONTON, FL 33534-5100
(813) 335-8296
(813) 671-4645
Mailing address
PO BOX 1275, RIVERVIEW, FL 33568-1275
(813) 335-8296
(813) 671-4645
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/06/2008
Last updated
07/15/2010
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