Individual
AMANDA GRIFFIN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
OT003237
GA
225X00000X
Occupational Therapist
Primary
OT003237
GA
Other
Enumeration date
03/08/2006
Last updated
09/21/2018
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