Individual
ALEXIS WAGENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
160 PITTYPAT PL, MCDONOUGH, GA 30253-5554
(770) 820-5805
Mailing address
160 PITTYPAT PL, MCDONOUGH, GA 30253-5554
(770) 820-5805
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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