Individual
PENINA WAGSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
129 FARMINGTON AVE, WATERBURY, CT 06710-1739
(347) 756-0707
Mailing address
129 FARMINGTON AVE, WATERBURY, CT 06710-1739
(347) 756-0707
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
235Z00000X
Speech-Language Pathologist
Primary
7894
CT
Other
Enumeration date
12/12/2019
Last updated
01/16/2025
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