Individual
BARBARA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 CHARLES ST, MAYNARD, MA 01754-2239
(978) 897-6961
Mailing address
13 CHARLES ST, MAYNARD, MA 01754-2239
(978) 897-6961
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6308
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0703761
—
MA
01
—
OT0130
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/29/2007
Last updated
07/08/2007
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