Individual
LORRIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 W HIGHWAY 46, SPENCER, IN 47460
(812) 829-2331
Mailing address
4572 S REDWOOD ST, TERRE HAUTE, IN 47802-4536
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22008399A
IN
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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