Individual
BRIDGET WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
635 59TH ST, DOWNERS GROVE, IL 60516-1436
(630) 719-5815
Mailing address
635 59TH ST, DOWNERS GROVE, IL 60516-1436
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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