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1497779466
JANICE K. WAGNER
BOSTON, MA
NPI
1497779466
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MA 105968)
Enumeration Date
2006-07-26
Last Update Date
2009-04-08
Business Address
-- JANICE K. WAGNER LICSW
147 MILK ST
BOSTON, MA 02109-4806
Phone number: 617-654-7300
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Mailing Address
-- JANICE K. WAGNER LICSW
147 MILK ST PROVIDER ENROLLMENT 9TH FLOOR
BOSTON, MA 02109-4806
Phone number: 617-559-8051
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