Individual
LINDSEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10879 CLEMSON BLVD, SENECA, SC 29678-1303
(864) 482-0085
(864) 482-0072
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OTP-OT-LIC-10601
MT
225X00000X
Occupational Therapist
Primary
—
SC
Other
Enumeration date
07/17/2024
Last updated
08/13/2024
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