Individual
AMANDA MARY-BETH WAGNILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
105 TERRACE VIEW DR, ITHACA, NY 14850-6256
(607) 220-6656
Mailing address
105 TERRACE VIEW DR, ITHACA, NY 14850-6256
(607) 220-6656
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-308554
—
374J00000X
Doula
—
—
Other
Enumeration date
05/27/2014
Last updated
09/15/2025
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