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1285275446
DIANNE WAGONER
ROCKAWAY, NJ
NPI
1285275446
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NJ 37CA000098200)
Enumeration Date
2019-09-30
Last Update Date
2019-09-30
Business Address
DIANNE WAGONER
200 E MAIN ST
ROCKAWAY, NJ 07866-3614
Phone number: 973-229-3198
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Mailing Address
DIANNE WAGONER
8 RESERVOIR RD
LAKE HOPATCONG, NJ 07849-1712
Phone number: 973-663-1303
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