Individual
BRANDEN J WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
795 S TOWNSHIP ROAD 113, TIFFIN, OH 44883-9791
(419) 987-4440
Mailing address
795 S TOWNSHIP ROAD 113, TIFFIN, OH 44883-9791
(419) 987-4440
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
7401001
OH
251X00000X
Supports Brokerage Agency
—
OH
253Z00000X
In Home Supportive Care Agency
7401001
OH
253Z00000X
In Home Supportive Care Agency
—
OH
347C00000X
Private Vehicle
7401001
OH
347C00000X
Private Vehicle
—
OH
3747P1801X
Personal Care Attendant
7401001
OH
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
7401001
OH
376J00000X
Homemaker
—
OH
385H00000X
Respite Care
7401001
OH
385H00000X
Respite Care
—
OH
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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