Individual
MISS LAURA ASHLEE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP BCBA
Contact information
Practice address
54 CRABAPPLE LN, FRANKLIN PARK, NJ 08823-1416
(570) 343-1950
Mailing address
54 CRABAPPLE LN, FRANKLIN PARK, NJ 08823-1416
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-65537
—
235Z00000X
Speech-Language Pathologist
SL011331
PA
Other
Enumeration date
07/10/2014
Last updated
12/07/2023
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