| NPI | 1245853951 |
|---|---|
| Former Name | TAYLOR M WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 030814-01) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2025-09-01 |