Individual
MS. LEAORA L WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
1043 ORNDORFF CT, BRUNSWICK, MD 21716-1219
(301) 693-8479
Mailing address
1043 W. ORNDORFF COURT, BRUNSWICK, MD 21716-1219
(301) 693-8479
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11314102
MD
Other
Enumeration date
08/01/2013
Last updated
08/01/2013
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