Individual
MOLLY WAGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 SMITH ST, APT 4F, BROOKLYN, NY 11201-4347
(917) 846-0849
Mailing address
116 SMITH ST, APT 4F, BROOKLYN, NY 11201-4347
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
020420
NY
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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