Organization
FUNCTIONAL COACHING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLY WAGMAN (OWNER)
(917) 846-0849
Entity
Organization
Contact information
Practice address
116 SMITH ST APT 4F, BROOKLYN, NY 11201-6287
(917) 846-0849
Mailing address
116 SMITH ST APT 4F, BROOKLYN, NY 11201-6287
(917) 846-0849
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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