Individual
AMELIA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1342 SE 46TH LN, CAPE CORAL, FL 33904-8617
(239) 351-4787
Mailing address
546 BRUCE CIR, FORT MYERS, FL 33919-3103
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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