Jennifer L Wagner
Occupational Therapy Assistant in Justin, TX. Individual provider (NPI-1).
NPI number1003370545
StatusActive
Last updated in NPPESJan 29, 2019
Details
- NPI
- 1003370545
- Entity type
- Individual (NPI-1)
- Name
- Jennifer L Wagner
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 29, 2019
- Last updated
- Jan 29, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 212402 | TX | Yes |
Practice location
120 Meadow View DrJustin, TX 76247-9639
Phone 940-648-2731
Mailing address
10711 Justin Cemetery Rd Lot 264Justin, TX 76247-8032
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