Individual
KRISTI WAGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13835 N TATUM BLVD STE 9429, PHOENIX, AZ 85032-5590
(480) 242-5903
Mailing address
13835 N TATUM BLVD STE 9429, PHOENIX, AZ 85032-5590
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320411
—
AZ
Enumeration date
03/04/2019
Last updated
03/04/2019
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