Individual
PATRICIA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
11230 CORNELL PARK DR, BLUE ASH, OH 45242-1825
(513) 880-6800
Mailing address
11230 CORNELL PARK DR, BLUE ASH, OH 45242-1825
(513) 880-6800
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT001966
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2187155
—
OH
Enumeration date
01/11/2008
Last updated
04/08/2020
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