Individual
AVIVA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1273 53RD ST, BROOKLYN, NY 11219-3865
(718) 435-5700
(718) 854-5495
Mailing address
1273 53RD ST, BROOKLYN, NY 11219-3865
(718) 435-5700
(718) 854-5495
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
099680
NY
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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