Individual
ALEXANDRIA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2338 W ROYAL PALM RD STE J, PHOENIX, AZ 85021-9339
(925) 899-1022
Mailing address
295 89TH ST STE 306, DALY CITY, CA 94015-1656
(877) 264-6747
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26547
CA
Other
Enumeration date
08/24/2017
Last updated
11/05/2024
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