Individual
BLAIR FARAM WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
9400 N CENTRAL EXPY, DALLAS, TX 75231-5027
(972) 794-7170
Mailing address
9400 N CENTRAL EXPY, DALLAS, TX 75231-5027
(214) 477-2954
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
107376
TX
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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