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1114693587
LISA WAGNER
CHICAGO, IL
NPI
1114693587
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2021-08-17
Last Update Date
2021-08-17
Business Address
LISA WAGNER
706 W 17TH ST APT 2F
CHICAGO, IL 60616-1220
Phone number: 630-709-8252
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Mailing Address
LISA WAGNER
706 W 17TH ST APT 2F
CHICAGO, IL 60616-1220
Phone number: 630-709-8252
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