Individual
ANASTASIA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2423 2ND AVE N, SAINT PETERSBURG, FL 33713-8826
(727) 560-5657
(727) 321-1975
Mailing address
2423 2ND AVE N, SAINT PETERSBURG, FL 33713-8826
(727) 560-5657
(727) 321-1975
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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