MARY WAGNER

KENOSHA, WI
NPI1033842075
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: WI  5738-27)
Enumeration Date2022-07-07
Last Update Date2022-07-07
Business Address
MARY WAGNER COTA
3415 SHERIDAN RD
KENOSHA, WI 53140-1924
Phone number: 262-657-6175
Mailing Address
MARY WAGNER COTA
5591 WHIRLAWAN LN
RACINE, WI 53402
Phone number:
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