Individual provider · Type 1 NPI
Lisa Wagner
Developmental Therapist · Chicago, IL
Practice location
706 W 17th St Apt 2F
Chicago, IL 60616-1220
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | None listed |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
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About NPI 1114693587
Lisa Wagner's National Provider Identifier is 1114693587, issued on Aug 17, 2021. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Chicago, IL. The record was last updated on Aug 17, 2021.