Individual
SUSAN WAGONLANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
101 BODIN CIR, 60TH MDOS/SGOY (OCCUPATIONAL THERAPY), TRAVIS AFB, CA 94535-1809
(707) 423-7816
Mailing address
101 BODIN CIR, 60TH MDOS/SGOY (OCCUPATIONAL THERAPY), TRAVIS AFB, CA 94535-1809
(707) 423-7816
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
0118
AL
Other
Enumeration date
05/11/2006
Last updated
08/14/2008
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