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1669801791
SAMANTHA WAGNER
HACKENSACK, NJ
NPI
1669801791
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NJ 44SL05714100)
Enumeration Date
2013-11-08
Last Update Date
2017-04-26
Business Address
-- SAMANTHA WAGNER
30 PROSPECT AVE
HACKENSACK, NJ 07601-1914
Phone number: 201-527-8663
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Mailing Address
-- SAMANTHA WAGNER
30 PROSPECT AVE
HACKENSACK, NJ 07601-1914
Phone number:
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