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Individual

MS. MEGAN THERESA WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6437 RUCKER RD, SUITE D, INDIANAPOLIS, IN 46220-4885
(317) 405-9016
Mailing address
564 STAFFORD DR, WESTFIELD, IN 46074-5809
(330) 321-3999

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005964A
IN
235Z00000X
Speech-Language Pathologist
46001920A
IN

Other

Enumeration date
01/23/2009
Last updated
02/19/2015
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