Individual
MRS. DEBORAH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
19126 PRAIRIE ST, LYTLE, TX 78052-3495
(210) 885-8214
Mailing address
PO BOX 1510, LYTLE, TX 78052-1510
(210) 885-8214
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
19279
TX
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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