Individual
MOLLY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
15955 NEW HALLS FERRY RD, FLORISSANT, MO 63031-1298
(417) 987-1297
Mailing address
16329 JUSTUS POST RD, CHESTERFIELD, MO 63017-4607
(417) 987-1297
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.012617
IL
225X00000X
Occupational Therapist
Primary
2018027382
MO
Other
Enumeration date
08/30/2018
Last updated
05/31/2023
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