Individual
MS. SUSAN ANGLIN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
205 N MONROE ST, MEDIA, PA 19063-3052
(610) 627-4654
Mailing address
391 KIRK LN, MEDIA, PA 19063-2217
(610) 627-4654
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC007001
PA
Other
Enumeration date
02/01/2015
Last updated
02/06/2015
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