Adelyn Lee Wagner, OTRL
Individual provider Active NPI Occupational Therapist · Hermann, MO
NPI 1699830331 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699830331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 000587 (MO)
- Practice address
- 509 W. 18TH St.
Hermann, MO 65041-0470 - Phone
- (573) 486-2191
- Fax
- (573) 486-5021
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000587 | MO | MD | Foot Surgery Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 000587 | MO | Yes |
Addresses
Primary practice location
509 W. 18TH St.
Hermann, MO 65041-0470
Mailing address
623 Epple Fricke Dr
Hermann, MO 65041-1703
Phone (573) 486-5473
Other providers in Hermann, MO
- Amanda Truetken
- Two Rivers Physicians, PLLC.
- Mollie Ulsas
- Tanner Jansen Unger
- Victorian Manor of Hermann Inc
- Kenneth R Wehrenberg
- Stephanie Williams
- Tracy Lynn Williams
- Krystal L Witthaus
All providers in Hermann, MO · Occupational Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.