Organization
RED WAGON CHILDREN'S THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA B WENZL M.ED. (OWNER)
(704) 606-6885
Entity
Organization
Contact information
Practice address
516 WOODBERRY DR, MOORESVILLE, NC 28115-2862
(704) 606-6885
Mailing address
516 WOODBERRY DR, MOORESVILLE, NC 28115-2862
(704) 606-6885
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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