Individual
STEPHANIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4562 WESTINGHOUSE ST STE A, VENTURA, CA 93003-5797
(805) 644-8255
Mailing address
327 W PARK ROW AVE, VENTURA, CA 93001-1873
(805) 509-2844
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
15537
CA
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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