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1306604392
EVAN DAVID WAGSTAFF
BINGHAMTON, NY
NPI
1306604392
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 122465-01)
Enumeration Date
2024-03-13
Last Update Date
2024-03-13
Business Address
EVAN DAVID WAGSTAFF LMSW
184 COURT ST
BINGHAMTON, NY 13901-3515
Phone number: 607-584-4465
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Mailing Address
EVAN DAVID WAGSTAFF LMSW
602 TERRACE RD
ENDWELL, NY 13760-5850
Phone number: 607-752-0181
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