Judith Wagner

NPI 1659458016 · on the registry since 2006 · sole proprietor

Practice

Address: 23161 Greater Mack Ave
Saint Clair Shores, MI 48080
Phone: (586) 779-8892
Fax: (586) 779-2869
Organisation at this address: David Gilboe & Associates, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

Registry record

Primary taxonomy: 225100000X
225100000X
Licence states on file: MI
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2007-07-08

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 Michigan