Individual
HAILEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
529 WESTPORT RD, ELIZABETHTOWN, KY 42701-2923
(270) 807-0316
Mailing address
6584 STATE ROUTE 1245, ROCKPORT, KY 42369-9731
(812) 598-9416
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
296345
KY
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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