KIMBERLY WAGNER (NPI# 1861885477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861885477 |
Entity Type | Individual |
Full Name | KIMBERLY WAGNER |
Credential | MS, OTRL |
Practice Address |
23936 Michigan Ave Dearborn MI 48124-1833 |
Mailing Address |
15045 Belmont Ave Allen Park MI 48101-1605 |
Practice Telephone | 3132784601 |
Mailing Telephone | 3133786648 |
Enumeration Date | 2015-03-07 |
Last Update Date | 2019-07-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | 5201001795 | MI | Other Service Providers |
N | 225X00000X | Occupational Therapist | 5201001795 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053755959 | Kimberly Wagner | Counselor | 533 Judy Ann Dr, Hahira, GA 31632-1303 | 2013-04-22 |
1164691465 | Kimberly H Wagner | Nurse Practitioner | 125 W Interstate 30, Royse City, TX 75189-7512 | 2008-02-21 |
1245352855 | Kimberly Wagner | Psychologist | 201 N Rose Ave, Room 32, Bloomington, IN 47405-1005 | 2007-04-04 |
1497379788 | Kimberly Ann Wagner | Registered Nurse | 6480 Technology Ave, Kalamazoo, MI 49009-8119 | 2020-06-02 |
1124542980 | Kimberly Marie Wagner | Specialist/Technologist | 59 Executive Park S Ste 1100, Atlanta, GA 30329-2208 | 2017-08-02 |
1093154122 | Kimberly Wagner | Family Medicine | 2970 Pierce Rd, Suite 2, Saginaw, MI 48604-8810 | 2013-06-21 |
1588008320 | Kimberly Wagner | Counselor | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2013-04-23 |
1104176593 | Kimberly N Wagner | Physical Therapist | 750 Coronado Center Dr, Suite 120, Henderson, NV 89052-5034 | 2012-09-13 |
1114237575 | Kimberly Ann Wagner | Licensed Practical Nurse | 1 Perryman St, Lebanon, IL 62254-1356 | 2010-10-19 |
1922325497 | Kimberly Lue Wagner | Psychiatry & Neurology | 2312 N Nevada Ave, Suite 100, Colorado Springs, CO 80907-5302 | 2010-04-23 |
Street Address |
23936 MICHIGAN AVE |
City | DEARBORN |
State | MI |
Zip Code | 48124-1833 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669691648 | Dearborn Speech and Sensory Center, Inc. | Speech-Language Pathologist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2007-04-25 |
1952851404 | Rachelle Bietler | Speech-Language Pathologist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2016-10-08 |
1598219966 | Katelyn Marie Smith | Speech-Language Pathologist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2016-08-15 |
1245680370 | Rose Cairo | Speech-Language Pathologist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2016-06-20 |
1851777676 | Michelle Calilung | Speech-Language Pathologist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2015-08-04 |
1932500501 | Lori Shaffer | Speech-Language Pathologist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2014-09-14 |
1033510821 | Dearborn Speech and Sensory Center, Inc | Clinic/Center | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2014-09-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
Find all providers in zip 48124 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568889251 | Independent Medical Associates PC | Specialist | 24825 Michigan Ave Ste B, Dearborn, MI 48124-1758 | 2014-03-20 |
1740544550 | Angela Patricia - Galeano Carlson | Specialist | 23910 Oak St, Dearborn, MI 48128-2202 | 2012-06-26 |
1427239458 | William G Nutting M.d.p.c. | Specialist | 1637 Monroe St, Dearborn, MI 48124-2912 | 2007-11-19 |
1548463151 | Susan Kusner | Specialist | 13020 Osborne St, Dearborn, MI 48126-3640 | 2007-06-10 |
1194859314 | Darapen C Chivalak | Specialist | 1640 Monroe St, Dearborn, MI 48124-2913 | 2007-03-16 |
1821159690 | Kirsten Clark | Specialist | 20031 Carlysle St, Suite 3, Dearborn, MI 48124-3803 | 2006-12-13 |
1306880471 | Hyun Sik Chang | Specialist | 3815 Pelham, Suite 5, Dearborn, MI 48124-3852 | 2006-06-16 |
1184664302 | John J. Bernick | Specialist | 751 S Military St, Dearborn, MI 48124-2107 | 2006-06-07 |
1710943683 | Peter L. Stevenson, Md, PC | Specialist | 2100 Monroe Street, Dearborn, MI 48124 | 2006-04-21 |
1134195480 | Raghda Chwikani | Specialist | 10326 W Warren Ave, Dearborn, MI 48126-1659 | 2006-02-27 |
Find all providers in DEARBORN |
Please comment or provide details below to improve the information on KIMBERLY WAGNER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.