Jennifer Wagner, MS, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

7165 Issued in AZ

Practice address

20329 N 59TH Ave
Glendale, AZ 85308-6853

Phone

(623) 500-2401

Fax

(623) 500-2401

NPI assigned

Oct 23, 2017

Last updated

Jun 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Lopez Quintero Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapy Tree, PLLC

  • Hearing and Speech Clinic/Center
  • Phoenix, AZ
  • NPI 1306240817

  Pediatrics

  NPD (past)
• Therapy Tree Group PLLC

  • Hearing and Speech Clinic/Center
  • Houston, TX
  • NPI 1689385973
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1982115432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 S 14TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425666",
            "telephone_number": "602-349-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20329 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086853",
            "telephone_number": "623-500-2401",
            "fax_number": "623-500-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JENNIFER",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "7165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LOPEZ QUINTERO",
            "credential": "MS, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Constance A. Vukas, LMFT
• Hanh Thuy Vuong, DC
• Huy Vuong, DO
• W L Judge Chiropractic Center P C
• Daisy Waanders, RD
• Lindsey Renee Wagner, PT, DPT
• Christa M Wagnon, RN, FNP
• Wagoner Care LLC
• Nicole R Wahlers
• Jennifer Wainwright

• Pediatric Occupational Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.