Individual
JONATHAN WAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10820 COLDWATER RD, FORT WAYNE, IN 46845-1241
(260) 755-1438
(260) 755-1566
Mailing address
10820 COLDWATER RD, FORT WAYNE, IN 46845-1241
(260) 755-1438
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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