TERESA LEE WAGNER

ITHACA, NY
NPI1336271477
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NY  R042129-1)
Enumeration Date2007-03-12
Last Update Date2007-07-08
Business Address
-- TERESA LEE WAGNER M.S.W.
215 N GENEVA ST
ITHACA, NY 14850-4135
Phone number: 607-227-1026
Mailing Address
-- TERESA LEE WAGNER M.S.W.
205 W NORTHVIEW RD
ITHACA, NY 14850-6041
Phone number: 607-273-6767