Individual
LEIGH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 TUDOR DR, BATON ROUGE, LA 70815-4878
(225) 278-5943
Mailing address
1650 TUDOR DR, BATON ROUGE, LA 70815-4878
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5423
LA
Other
Enumeration date
05/11/2009
Last updated
05/11/2009
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