Individual
MS. MARY JO WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
54 PARRAMATTA RD, BEVERLY, MA 01915-1970
(978) 921-8751
Mailing address
54 PARRAMATTA RD, BEVERLY, MA 01915-1970
(978) 921-8751
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
422
MA
Other
Enumeration date
06/09/2006
Last updated
07/08/2007
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