Individual
MARY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
775 S MAIN ST, CHELSEA, MI 48118-1383
(734) 593-6000
Mailing address
775 S MAIN ST, CHELSEA, MI 48118-1383
(734) 593-6000
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
225800000X
Recreation Therapist
59993
—
Other
Enumeration date
03/14/2023
Last updated
03/16/2023
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