National Provider Identifier

Stephanie Wagner

Stephanie Wagner is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Fairport, NY and a listed phone number of (585) 641-0304.

NPI 1104291574Fairport, NYSpeech-Language Pathologist

Profile Overview

NPI
1104291574
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
December 09, 2015
Last Updated
December 09, 2015

Practice Location

  • 1387 Fairport RD
  • Fairport, NY 14450-2003

Phone: (585) 641-0304

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1104291574
Entity Type
Individual
Last Name
Wagner
First Name
Stephanie
Mailing Street Address
1387 Fairport RD
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-2003
Mailing Country
US
Practice Street Address
1387 Fairport RD
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-2003
Practice Country
US
Practice Phone
(585) 641-0304
Enumeration Date
December 09, 2015
Last Updated
December 09, 2015
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)