Individual
MRS. AMY ELIZABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CF-SLP
Contact information
Practice address
631 MAIN STREET, RICHFIELD, PA 17086
(717) 694-3434
(717) 694-3148
Mailing address
188 LENOR DR, STATE COLLEGE, PA 16801-6711
(404) 903-7712
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PS1000630
PA
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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