Individual
MELANIE LEANNE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119009765
VA
225X00000X
Occupational Therapist
2022022632
MO
225X00000X
Occupational Therapist
Primary
474782
OR
Other
Enumeration date
06/18/2022
Last updated
05/25/2026
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