Individual
CORINNE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SP. ED. TEACHER
Contact information
Practice address
6800 PITTSFORD PALMYRA RD, SUITE 380, FAIRPORT, NY 14450-3584
(585) 223-5090
Mailing address
6800 PITTSFORD PALMYRA RD, SUITE 380, FAIRPORT, NY 14450-3584
(585) 223-5090
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
673689121
NY
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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