| Carly Marie Wagner, MS, CCC-SLP | |
|
742 Sterbenz Dr, St Croix Therapy, Hudson, WI 54016-8327 | |
| (715) 386-2128 | |
| (715) 386-6119 |
| Full Name | Carly Marie Wagner |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 742 Sterbenz Dr, Hudson, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457692428 | NPI | - | NPPES |
| 3781 | Other | WI | WISCONSIN LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 3781 (Wisconsin) | Primary |
| Provider Name | Fairview Express Care |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
| Provider Name | Healtheast Outpatient Services Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1225382526 PECOS PAC ID: 0941447304 Enrollment ID: O20130503000040 |
| Provider Name | Optage Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1801517230 PECOS PAC ID: 2264619345 Enrollment ID: O20221206001945 |
| Mailing Address | Practice Location Address |
|---|---|
| Carly Marie Wagner, MS, CCC-SLP 742 Sterbenz Dr, St Croix Therapy, Hudson, WI 54016-8327 Ph: (715) 386-2128 | Carly Marie Wagner, MS, CCC-SLP 742 Sterbenz Dr, St Croix Therapy, Hudson, WI 54016-8327 Ph: (715) 386-2128 |
Mrs. Brooke Catherine John, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 742 Sterbenz Dr, Hudson, WI 54016 Phone: 715-386-2128 | |
Casey Nichole Depauw, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1123 Briarwood Ct, Hudson, WI 54016 Phone: 517-212-5814 | |
Mrs. Jeanne Claire Pratt, MST, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2705 Enloe St, Hudson, WI 54016 Phone: 715-386-2128 Fax: 715-386-6119 | |
Susan Bopray, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 742 Sterbenz Dr, Hudson, WI 54016 Phone: 715-386-2128 Fax: 715-386-6119 | |
Stephanie Lynn Laszczkowski, CCC-SLP Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 2705 Enloe St, Hudson, WI 54016 Phone: 715-690-2600 | |
Samantha Johnson, MS, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 2705 Enloe St, Hudson, WI 54016 Phone: 715-690-2600 | |
Dr. Susan L Halseth, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1011 5th St, Hudson, WI 54016 Phone: 715-381-6963 |