Individual
SIENNA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 SPRINGHOUSE CIR, STONE MOUNTAIN, GA 30087-6741
(678) 684-3800
Mailing address
1192 HAVEN BROOK LN NE, BROOKHAVEN, GA 30319-2667
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP011157
GA
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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