Individual
KATELYN NOEL WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
7450 E DUNDAS LN, CLAREMONT, IL 62421-2129
(812) 929-8906
Mailing address
7450 E DUNDAS LN, CLAREMONT, IL 62421-2129
(812) 929-8906
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012099
IL
Other
Enumeration date
11/16/2018
Last updated
12/27/2024
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