BRIAN R. WAGNER

VALLEY STREAM, NY
NPI1831204270
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  10434)
Enumeration Date2006-08-19
Last Update Date2007-07-08
Business Address
Mr. BRIAN R. WAGNER M.A. C.A.S.A.C.
73 S CENTRAL AVE
VALLEY STREAM, NY 11580-5402
Phone number: 516-872-9698
Mailing Address
Mr. BRIAN R. WAGNER M.A. C.A.S.A.C.
73 S CENTRAL AVE
VALLEY STREAM, NY 11580-5402
Phone number: 516-872-9698
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