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Individual

JANISSA J WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17575 STATE ROUTE M, EDGAR SPRINGS, MO 65462-8303
(573) 578-3830
Mailing address
17575 STATE ROUTE M, EDGAR SPRINGS, MO 65462-8303
(573) 578-3830

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary

Other

Enumeration date
04/14/2025
Last updated
04/14/2025
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