Individual
MRS. JUDITH MARIE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA/CRC
Contact information
Practice address
699 HERTEL AVE, SUITE 350, BUFFALO, NY 14207-2341
(716) 831-1977
Mailing address
3020 BAILEY AVE, BUFFALO, NY 14215-2814
(716) 831-1800
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00013644
NY
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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