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Organization

LEEANN WAGNER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEEANN WAGNER LPC, LCADC (PRIVATE PRACTIONER)
(201) 522-5108
Entity
Organization

Contact information

Practice address
18 KINGS HWY STE 202, MIDDLETOWN, NJ 07748-2509
(201) 522-5108
Mailing address
81 LEONARD AVE, LEONARDO, NJ 07737-1742
(201) 522-5108

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00483700
NJ

Other

Enumeration date
02/02/2017
Last updated
03/12/2020
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