Jennifer Wagner, MS, OTR/L

Occupational Therapist, Pediatrics in Glendale, AZ. Individual provider (NPI-1).

NPI number1982115432

StatusActive

Last updated in NPPESJun 18, 2019

Details

NPI: 1982115432
Entity type: Individual (NPI-1)
Name: Jennifer Wagner
Credential: MS, OTR/L
Sex: Female
Sole proprietor: No
Enumeration date: Oct 23, 2017
Last updated: Jun 18, 2019

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225XP0200X	Occupational Therapist, Pediatrics	7165	AZ	Yes

Other names

Jennifer Lopez Quintero (Former Name)

Practice location

20329 N 59th Ave
Glendale, AZ 85308-6853

Phone 623-500-2401 · Fax 623-500-2401

Mailing address

7505 S 14th St
Phoenix, AZ 85042-5666

Phone 602-349-8212

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Pediatric Occupational Therapist providers in Glendale, AZ

All 12 Pediatric Occupational Therapist providers in Glendale · All 7,642 providers in Glendale

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