Individual
BONNIE K WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. / CCC-SLP
Contact information
Practice address
1501 12TH AVE S, NASHVILLE, TN 37203-4909
(615) 933-0070
(615) 383-9489
Mailing address
1501 12TH AVE S, NASHVILLE, TN 37203-4909
(615) 933-0070
(615) 383-9489
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3246
TN
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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