Individual
DONNA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
660 N WESTMORELAND RD, LAKE FOREST, IL 60045-1659
(847) 535-8962
(847) 535-7847
Mailing address
56 E CLARE CT, PALATINE, IL 60067-9412
(847) 962-9229
(847) 535-7847
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.008880
IL
Other
Enumeration date
04/06/2007
Last updated
03/18/2010
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