Individual
ANNA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 GOLD STAR BLVD, WORCESTER, MA 01606-2738
(508) 459-6400
Mailing address
24 LOUDON ST APT 3, WORCESTER, MA 01610-5400
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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