Individual
MRS. MARY ELIZABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
525 W OAKLAND AVE, JOHNSON CITY, TN 37604-1672
(423) 383-8470
Mailing address
525 W OAKLAND AVE, JOHNSON CITY, TN 37604-1672
(423) 383-8470
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/18/2017
Last updated
07/21/2022
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