Individual
BRITTANY WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4532 PENNYPACK ST, PHILADELPHIA, PA 19136-2112
(847) 306-9843
Mailing address
4532 PENNYPACK ST, PHILADELPHIA, PA 19136-2112
(215) 783-2362
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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