Individual
LIA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3211 LASSITER ST, DURHAM, NC 27707-3879
(518) 928-5019
Mailing address
3211 LASSITER ST, DURHAM, NC 27707-3879
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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