Individual
VINCE JOHN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
104 TROY AVE, JUNEAU, AK 99801-1453
(907) 586-7606
Mailing address
104 TROY AVE, JUNEAU, AK 99801-1453
(907) 586-7606
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPS143
AK
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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