National Provider Identifier
Teresa Lee Wagner, M.S.W.
Teresa Lee Wagner, M.S.W. is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (607) 227-1026.
Profile Overview
- NPI
- 1336271477
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- March 12, 2007
- Last Updated
- July 08, 2007
Practice Location
- 215 N Geneva St
- Ithaca, NY 14850-4135
Phone: (607) 227-1026
Mailing Address
- 205 W Northview RD
- Ithaca, NY 14850-6041
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1336271477
- Entity Type
- Individual
- Last Name
- Wagner
- First Name
- Teresa
- Middle Name
- Lee
- Credential
- M.S.W.
- Mailing Street Address
- 205 W Northview RD
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-6041
- Mailing Country
- US
- Mailing Phone
- (607) 273-6767
- Practice Street Address
- 215 N Geneva St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-4135
- Practice Country
- US
- Practice Phone
- (607) 227-1026
- Enumeration Date
- March 12, 2007
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)
- Other Identifiers
- 566791 (NY, Value Options)