Provider Demographics
NPI:1619784402
Name:WANDNER, MARNI (NBC-HWC)
Entity type:Individual
Prefix:
First Name:MARNI
Middle Name:
Last Name:WANDNER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 5TH AVE # 153
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3316
Mailing Address - Country:US
Mailing Address - Phone:917-992-2530
Mailing Address - Fax:
Practice Address - Street 1:406 5TH AVE # 153
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3316
Practice Address - Country:US
Practice Address - Phone:917-992-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach