Individual
AUDREY WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
34515 9TH AVE S, FEDERAL WAY, WA 98003-6761
(253) 944-7970
Mailing address
35535 6TH AVE SW, FEDERAL WAY, WA 98023-8110
(253) 874-5445
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60973136
WA
Other
Enumeration date
08/20/2018
Last updated
11/09/2023
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