Individual
CHERYL LYNN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 WREN ST, SACANDAGA SCHOOL, SCOTIA, NY 12302
(518) 386-4311
Mailing address
1 RAPP RD, ADVANCED THERAPY, ALBANY, NY 12203
(518) 867-3061
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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