Individual
DIAMON WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
5265 E 126TH ST APT 101, CLEVELAND, OH 44125-3061
(216) 630-4620
Mailing address
5265 E 126TH ST APT 101, CLEVELAND, OH 44125-3061
(216) 630-4620
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
600396451121
OH
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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