Individual
SARAH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
11460 W WASHINGTON BLVD, LOS ANGELES, CA 90066-6030
(240) 543-7162
Mailing address
11460 W WASHINGTON BLVD, LOS ANGELES, CA 90066-6030
(240) 543-7162
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2023
Last updated
09/16/2024
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