Individual
STEPHANIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2532 N. FOURTH ST, #481, FLAGSTAFF, AZ 86004-8600
(928) 226-1563
Mailing address
12234 MENSA CT, BELLEMONT, AZ 86015-5097
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP11394
AZ
Other
Enumeration date
09/27/2018
Last updated
12/04/2025
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