Individual
LEEANN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
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
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00483700
NJ
Other
Enumeration date
06/10/2009
Last updated
03/12/2020
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