Individual
MICHELLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17732 HIGHLAND RD STE G254, BATON ROUGE, LA 70810-3846
(225) 910-5014
Mailing address
17732 HIGHLAND RD STE G254, BATON ROUGE, LA 70810-3846
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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