Individual
MRS. LISA MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2830 CAROL RD, YORK, PA 17402-3852
(865) 531-2204
Mailing address
115 GLENRAY CT, NEW FREEDOM, PA 17349-8734
(717) 235-1277
(410) 296-6745
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC004200L
PA
Other
Enumeration date
08/31/2009
Last updated
12/04/2015
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