Individual
MELANIE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
256 NEW BRITAIN AVE, NEWINGTON, CT 06111-4416
(860) 666-5689
(860) 666-2086
Mailing address
143 MORGAN FARMS DR, SOUTH WINDSOR, CT 06074-1373
(860) 268-2371
(860) 666-2086
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004060
CT
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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