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Individual

MR. JAY A. WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S. CCC-SLP

Contact information

Practice address
1830 BUTERBAUGH RD, CHERRY TREE, PA 15724-9746
(724) 309-1030
Mailing address
1830 BUTERBAUGH RD, CHERRY TREE, PA 15724-9746
(724) 309-1030

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL006248L
PA

Other

Enumeration date
03/03/2012
Last updated
03/03/2012
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