Individual
JOHN EDWARD WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
53 ORCHARD ST, CLIFTON, NJ 07013-1832
(973) 773-7600
(973) 773-7011
Mailing address
53 ORCHARD ST, CLIFTON, NJ 07013-1832
(973) 773-7600
(973) 773-7011
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06420400
NJ
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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