Individual
JORDAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1015 NW 56TH TER, GAINESVILLE, FL 32605-4481
(352) 835-5520
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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