Individual
HALEY WAGONBLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3630 GEORGE WASHINGTON MEM HWY, YORKTOWN, VA 23693-3350
(757) 690-9508
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/29/2019
Last updated
12/29/2019
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