Individual
HEATHER WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5020 NW VALLEY VIEW RD, BLUE SPRINGS, MO 64015-2345
(816) 874-3670
Mailing address
621 NE 5TH ST, BLUE SPRINGS, MO 64014-2976
(573) 579-5273
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016026452
MO
Other
Enumeration date
08/11/2016
Last updated
05/03/2019
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