Individual
HANNAH EMILE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
196 JUKYKA LN, CRANE, MO 65633-6269
(417) 689-6576
Mailing address
PO BOX 224, CLEVER, MO 65631-0224
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2015028347
MO
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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