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Individual

LINDSAY WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
600 EVERGREEN DR FL 2, GLEN MILLS, PA 19342-1053
(800) 321-9999
(484) 840-1603
Mailing address
833 CHESTNUT ST STE 520, PHILADELPHIA, PA 19107-4430
(267) 592-6191
(267) 339-3761

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056-011542
IL
225X00000X
Occupational Therapist
Primary
OC016363
PA

Other

Enumeration date
01/16/2013
Last updated
08/23/2019
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