Individual
KATHERINE ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT
Contact information
Practice address
10294 E 96TH ST, FISHERS, IN 46037-9497
(317) 288-7572
Mailing address
5469 E 79TH ST, INDIANAPOLIS, IN 46250-1705
(812) 607-0613
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
31006490A
IN
Other
Enumeration date
11/22/2017
Last updated
12/29/2025
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