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Individual

MRS. GERRI LYNNE WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
459 PHILO ROAD, GST BOCES, ELMIRA, NY 14903
(607) 739-3581
(607) 795-5305
Mailing address
6312-1 WEST RIVER ROAD, NICHOLS, NY 13812
(607) 259-1933

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
R041840
NY

Other

Enumeration date
10/15/2011
Last updated
10/15/2011
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