Individual
MS. ELIZABETH BAILEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTRL
Contact information
Practice address
7161 W Q AVE, KALAMAZOO, MI 49009-5951
(269) 870-7334
Mailing address
6364 WINDDRIFT AVE, KALAMAZOO, MI 49009-8923
(269) 873-0910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008500
MI
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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