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1144501446
MARITA LOANE WAGNER
PHILADELPHIA, PA
NPI
1144501446
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: PA SL002107L)
Enumeration Date
2011-08-31
Last Update Date
2011-08-31
Business Address
Miss MARITA LOANE WAGNER CCC-SLP
114 W ALLENS LN
PHILADELPHIA, PA 19119-4102
Phone number: 215-247-4034
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Mailing Address
Miss MARITA LOANE WAGNER CCC-SLP
114 W ALLENS LN
PHILADELPHIA, PA 19119-4102
Phone number: 215-247-4034
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