Individual
JODY WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 E NEWTON ST, PARIS, IL 61944-2421
(217) 466-6170
Mailing address
509 E NEWTON ST, PARIS, IL 61944-2421
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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