Olivia Joy Wagner, HIS
Hearing Instrument Specialist in Maplewood, MO. Individual provider (NPI-1).
NPI number1922873751
StatusActive
Last updated in NPPESNov 21, 2023
Details
- NPI
- 1922873751
- Entity type
- Individual (NPI-1)
- Name
- Olivia Joy Wagner
- Credential
- HIS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 21, 2023
- Certification date
- Nov 21, 2023
- Last updated
- Nov 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 237700000X | Hearing Instrument Specialist | 2016042392 | MO | Yes |
Practice location
2100 Maplewood Commons DrMaplewood, MO 63143-1015
Phone 314-644-3056
Mailing address
2100 Maplewood Commons DrMaplewood, MO 63143-1015
Phone 314-644-3056
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