Individual
ANNA GRACE WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 RIVERSIDE DR, MOUNT AIRY, NC 27030-3850
(336) 786-8355
Mailing address
215 OAK HILL DR, MOUNT AIRY, NC 27030-7484
(336) 755-9033
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
30003090
NC
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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