| Doctor Name: | MS. JOANNE L WAGNER |
| NPI Number: | 1275688145 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | JOANNE L WAGNER |
| License Number: | |
| Business Practice Address: | 10353 Dearlove Rd Apt 1a Glenview, IL - 600253637 |
| Business Phone Number: | 8476997301 |
| Business Fax Number: | 8476995960 |
| Mailing Address: | 10353 Dearlove Rd Apt 1a, P.o. Box 276 GLENVIEW |
| State: | IL |
| Postal Code: | 600253637 |
| Phone Number: | 8476997301 |
| Fax Number: | 8476995960 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |