Individual
EMMA ELIZABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 N PENNSYLVANIA ST APT 413, INDIANAPOLIS, IN 46204-2388
(708) 625-4165
Mailing address
421 N PENNSYLVANIA ST APT 413, INDIANAPOLIS, IN 46204-2388
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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