Individual
ANGELLE WAGUESPACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7168 HIGHWAY 44, GONZALES, LA 70737-8121
(225) 647-6719
Mailing address
7168 HIGHWAY 44, GONZALES, LA 70737-8121
(225) 647-6719
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z11964
LA
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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