Individual
CECILIA ANN WAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,CCC-SLP
Contact information
Practice address
400 PANTHER LANE, MAYPEARL, TX 76064-0040
(972) 435-1099
Mailing address
5485 ORANGE TREE LN, MIDLOTHIAN, TX 76065-4619
(903) 641-2589
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18035
TX
Other
Enumeration date
07/16/2007
Last updated
06/30/2022
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