Individual
WILSON BAGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 SOUTHARD ST, TRENTON, NJ 08609-1020
(609) 396-4557
Mailing address
934 GREENWOOD AVE, TRENTON, NJ 08609-2212
(609) 396-4557
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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