Individual
MS. DEBBI WAGNER SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. BCABA
Contact information
Practice address
4890 WAGON MASTER TRL, MICCO, FL 32976-2736
(772) 664-1620
Mailing address
550 SAINT JOHNS ST, COCOA, FL 32922-7241
(772) 713-6978
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-02-0614
FL
251S00000X
Community/Behavioral Health Agency
Primary
103K00000X
FL
Other
Enumeration date
02/21/2013
Last updated
02/21/2013
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