Deyounga Wagner

NPI 1306354568 · on the registry since 2018

Practice

Address: 629 Phoenix Dr
Virginia Beach, VA 23452
Phone: (757) 837-0761
Organisation at this address: Source One Mobility, Inc
Sentara Therapy Solutions, Llc
Lumapaths Behavioral Services, Pllc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 93

Registry record

Primary taxonomy: Behavior Technician
106S00000X
Licence states on file: VA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2018-01-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia