Individual
CASEY JO WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2222 MARTIN LUTHER KING JR BLVD, EUGENE, OR 97401-2475
(541) 224-6987
Mailing address
355 MARCHE CHASE DR APT 200, EUGENE, OR 97401-8876
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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