Individual
TORI SMITH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1822 NIGHTHAWK DR, FLORENCE, SC 29501-8140
(843) 413-9629
Mailing address
1822 NIGHTHAWK DR, FLORENCE, SC 29501-8140
(843) 413-9629
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
768
SC
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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