National Provider Identifier
Imani Tacuma Wagstaff I
Imani Tacuma Wagstaff I is listed in the NPPES registry with a primary specialty of Counselor in Rochester, NY and a listed phone number of (585) 256-7500.
Source: public NPPES record, last updated January 11, 2021. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1578070512
- Provider Type
- Individual
- Primary Specialty
- Counselor
- Enumeration Date
- December 29, 2017
- Last Updated
- January 11, 2021
Practice Location
- 1 Mustard St
- Rochester, NY 14609-6980
Phone: (585) 256-7500
Specialties
- Counselor (101Y00000X)
- Marriage & Family Therapist (106H00000X)
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Full Record
- NPI
- 1578070512
- Entity Type
- Individual
- Last Name
- Wagstaff
- First Name
- Imani
- Middle Name
- Tacuma
- Name Suffix
- I
- Mailing Street Address
- 1 Mustard St
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14609-6980
- Mailing Country
- US
- Mailing Phone
- (585) 256-7500
- Practice Street Address
- 1 Mustard St
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14609-6980
- Practice Country
- US
- Practice Phone
- (585) 256-7500
- Enumeration Date
- December 29, 2017
- Last Updated
- January 11, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- January 07, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Counselor (101Y00000X), Marriage & Family Therapist (106H00000X)