Individual
DIANA J WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
8850 STANFORD BLVD STE 1700, COLUMBIA, MD 21045-4765
(410) 964-9511
(410) 964-9513
Mailing address
8850 STANFORD BLVD STE 1700, COLUMBIA, MD 21045-4765
(410) 964-9511
(410) 964-9513
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
562
MD
Other
Enumeration date
09/30/2006
Last updated
08/02/2023
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