Individual
WHITNEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2788 HIGHWAY 140, BROOKVILLE, KS 67425-9238
(131) 653-0527
Mailing address
2788 HIGHWAY 140, BROOKVILLE, KS 67425-9238
(131) 653-0527
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01227
KS
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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