| Doctor Name: | CORBIN D WAGNER |
| NPI Number: | 1336587187 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., C.F.-S.L.P. |
| License Number: | 62 |
| Business Practice Address: | 161 Klevin St Suite 103 Anchorage, AK - 995081508 |
| Business Phone Number: | 9075618060 |
| Business Fax Number: | 9075636172 |
| Mailing Address: | 161 Klevin St, Suite 103 ANCHORAGE |
| State: | AK |
| Postal Code: | 995081508 |
| Phone Number: | 9075618060 |
| Fax Number: | 9075636172 |
| NPI Enumeration Date: | 06/13/2013 |
| NPI Last Update Date: | 06/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 62 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| 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 |