Individual
CLAIRE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15600 36TH AVE N STE 120, PLYMOUTH, MN 55446-3687
(763) 595-0812
Mailing address
15600 36TH AVE N STE 120, PLYMOUTH, MN 55446-3687
(763) 595-0812
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
116328
TX
235Z00000X
Speech-Language Pathologist
Primary
528506
MN
Other
Enumeration date
01/22/2020
Last updated
02/08/2023
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