NPI 1023668126

Brandy L Wagner

Practitioner Behavior Technician O Fallon, IL

Practice location

Address: 634 N Main St STE 4, O Fallon, IL 62269-3746
Phone: (618) 726-5870
Mailing address: 21600 Oxnard St STE 1800, Woodland Hills, CA 91367-7807

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

Other Behavior Technician providers in Illinois →

Registry record

NPI: 1023668126
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Sep 2019
Record last updated: 19 Sep 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.