Individual
KETURAH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPD
Contact information
Practice address
636 SYCAMORE ST, BUFFALO, NY 14212-1132
(716) 243-8598
Mailing address
636 SYCAMORE ST, BUFFALO, NY 14212-1132
(716) 243-8598
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
6799
NY
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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