National Provider Identifier
Ruth A Godwin Wagner, O.T.
Ruth A Godwin Wagner, O.T. is listed in the NPPES registry with a primary specialty of Occupational Therapist in Clyde, NY and a listed phone number of (315) 902-3100.
Profile Overview
- NPI
- 1679857965
- Provider Type
- Individual
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- October 05, 2011
- Last Updated
- October 05, 2011
Practice Location
- 212 E. Dezeng St.
- Clyde Elementary School
- Clyde, NY 14433
Phone: (315) 902-3100
Mailing Address
- 1776 Powderly RD
- Waterloo, NY 13165-9415
Specialties
- Occupational Therapist (225X00000X)
Full Record
- NPI
- 1679857965
- Entity Type
- Individual
- Last Name
- Godwin Wagner
- First Name
- Ruth
- Middle Name
- A
- Name Prefix
- Mrs.
- Credential
- O.T.
- Mailing Street Address
- 1776 Powderly RD
- Mailing City
- Waterloo
- Mailing State
- NY
- Mailing ZIP Code
- 13165-9415
- Mailing Country
- US
- Mailing Phone
- (315) 729-0779
- Practice Street Address
- 212 E. Dezeng St.
- Practice Address Line 2
- Clyde Elementary School
- Practice City
- Clyde
- Practice State
- NY
- Practice ZIP Code
- 14433
- Practice Country
- US
- Practice Phone
- (315) 902-3100
- Enumeration Date
- October 05, 2011
- Last Updated
- October 05, 2011
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Occupational Therapist (225X00000X)