Individual
MS. OLIVIA C. VAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
860 LOWER FERRY RD STE 2, EWING, NJ 08628-3516
(609) 245-0006
Mailing address
860 LOWER FERRY RD STE 2, EWING, NJ 08628-3516
(609) 245-0006
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
41YA00025500
NJ
237600000X
Audiologist-Hearing Aid Fitter
25MG000646000
NJ
Other
Enumeration date
10/02/2008
Last updated
03/14/2018
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