Individual
RILEY ANN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7 DUNWOODY PARK, ATLANTA, GA 30338-6711
(678) 616-1330
Mailing address
3270 KINGSHOUSE CMNS, ALPHARETTA, GA 30022-7608
(630) 649-9190
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008662
GA
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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