Individual
KATHIE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4901 NORTHSHORE DR, NORTH LITTLE ROCK, AR 72118-5293
(501) 791-3331
(501) 791-0294
Mailing address
4901 NORTHSHORE DR, NORTH LITTLE ROCK, AR 72118-5293
(501) 791-3331
(501) 791-0294
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/13/2008
Last updated
10/13/2008
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