Individual
CHARLOTTE RAE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CVRT
Contact information
Practice address
5000 S 5TH AVE BLDG 113, HINES, IL 60141-3030
(708) 202-2273
Mailing address
5000 S 5TH AVE BLDG 113 MAIL STOP 124, HINES, IL 60141-3030
(708) 202-2273
Taxonomy
Speciality
Code
Description
License number
State
2255R0406X
Blind Rehabilitation Specialist/Technologist
Primary
23297
IL
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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