Patrick Wagner
Behavior Technician in Raleigh, NC. Individual provider (NPI-1).
NPI number1023904232
StatusActive
Last updated in NPPESJun 16, 2025
Details
- NPI
- 1023904232
- Entity type
- Individual (NPI-1)
- Name
- Mr. Patrick Wagner
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 16, 2025
- Certification date
- Jun 15, 2025
- Last updated
- Jun 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
5121 Kingdom Way Ste 100Raleigh, NC 27607-6063
Phone 919-743-0204
Mailing address
5121 Kingdom Way Ste 100Raleigh, NC 27607-6063
Phone 919-743-0204
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