Individual
GRETCHEN ELIZABETH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1732 DEROCHE CIR, SUITE B, GRAMERCY, LA 70052-3548
(225) 868-0309
(225) 869-0271
Mailing address
311 S RIVER POINTE, LA PLACE, LA 70068-2958
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3389
LA
Other
Enumeration date
06/19/2009
Last updated
06/19/2009
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