Individual
MRS. JOAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 N MILLER RD, BLDG 150, FAIRLAWN, OH 44333-3770
(330) 630-1860
Mailing address
260 BROOK VIEW DR, CUYAHOGA FALLS, OH 44223-3533
(330) 815-1514
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA0853
OH
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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