Individual
COURTNEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1891 STATION PKWY NW, ANDOVER, MN 55304-3341
(763) 755-4275
Mailing address
1891 STATION PKWY NW, ANDOVER, MN 55304-3341
(763) 755-4275
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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