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Ty'Ara Wagner
NPI 1588250351 · on the registry since 2020
Practice
- Address
- 100 Columbia Dr
Linwood, NC 27299 - Phone
- (980) 267-2965
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- NC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-07-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina