Individual
MS. DEANNA D. WAGGY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
500 ARCADE AVE, ELKHART, IN 46514-2477
(574) 296-9100
(574) 293-1511
Mailing address
500 ARCADE AVE, ELKHART, IN 46514-2477
(574) 296-9100
(574) 293-1511
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000143A
IN
Other
Enumeration date
07/08/2005
Last updated
07/08/2007
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