Individual
ALEXANDRA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3074 30TH ST APT 2F, ASTORIA, NY 11102-2226
(607) 206-8422
Mailing address
3074 30TH ST APT 2F, ASTORIA, NY 11102-2226
(607) 206-8422
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021451
NY
Other
Enumeration date
04/11/2021
Last updated
04/11/2021
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