Individual
HEATHER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22415 SE 213ST ST, SUITE B103, MAPLE VALLEY, WA 98038
(425) 906-4300
Mailing address
22415 SE 213ST ST, SUITE B103, MAPLE VALLEY, WA 98038
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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