Wagner, Joanne L
Wagner, Joanne L is an sole proprietor health care provider with primary practice located at 368 Fourth St , Crossville TN 38555-4309. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Wagner, Joanne L can be contacted via phone (931) 484-3301.Contact Information
Primary practice address
368 Fourth St
Crossville TN 38555-4309
Phone: (931) 484-3301
Fax: (423) 622-1556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 6600 | Tennessee |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 146-000817 | Illinois |
Profile Details
| NPI number | 1275688145 |
|---|---|
| LBN Legal business name | Wagner, Joanne L |
| Credentials | SLP-CCC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 24th, 2007 |
| Last updated | Mar 11th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275688145 | NPPES |
| Illinois | Other | 146-000817 | STATE LICENCE |
| Illinois | Other | 6600 | STATE LICENCE |
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