Individual
MRS. JAIME VICTORIA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
825 OLD LANCASTER RD, SUITE 250, BRYN MAWR, PA 19010-3231
(610) 542-3288
(302) 542-3312
Mailing address
825 OLD LANCASTER RD, SUITE 250, BRYN MAWR, PA 19010-3231
(610) 542-3288
(302) 542-3312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
O1-0001197
DE
235Z00000X
Speech-Language Pathologist
Primary
SL010314
PA
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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