Individual
HANNAH JAYNE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
3351 W 84TH AVE, ANCHORAGE, AK 99502-5302
(907) 390-0492
Mailing address
3351 W 84TH AVE, ANCHORAGE, AK 99502-5302
(907) 390-0492
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
67
AK
235Z00000X
Speech-Language Pathologist
Primary
SLPS526
AK
Other
Enumeration date
08/05/2013
Last updated
02/09/2019
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