| Patricia Wagner, OT | |
| 11230 Cornell Park Dr, Blue Ash, OH 45242-1825 | |
| (513) 880-6800 | |
| Not Available | 
| Full Name | Patricia Wagner | 
|---|---|
| Gender | Female | 
| Speciality | Occupational Therapist - Pediatrics | 
| Location | 11230 Cornell Park Dr, Blue Ash, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1225214083 | NPI | - | NPPES | 
| 2187155 | Medicaid | OH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 225XP0200X | Occupational Therapist - Pediatrics | OT001966 (Ohio) | Primary | 
| Provider Name | Big Blue Canopy Llc | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1548820772 PECOS PAC ID: 4880029123 Enrollment ID: O20200115001259 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Patricia Wagner, OT 11230 Cornell Park Dr, Blue Ash, OH 45242-1825 Ph: (513) 880-6800 | Patricia Wagner, OT 11230 Cornell Park Dr, Blue Ash, OH 45242-1825 Ph: (513) 880-6800 | 
| Nadege Mondesir,  Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 10123 Alliance Rd Ste 300, Blue Ash, OH 45242 Phone: 513-676-3040 | |
| Tanner Elizabeth Rosenblum, OTD, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6100 Hagewa Dr, Blue Ash, OH 45242 Phone: 513-686-1720 | |
| Lauren Cornett,  Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4440 Carver Woods Dr, Blue Ash, OH 45242 Phone: 513-791-5688 | |
| Judi Pollak, MSOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5959 Hagewa Dr, Blue Ash, OH 45242 Phone: 513-686-1780 Fax: 513-791-4873 | |
| Abby O'brien Reagan, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5150 Belleview Ave, Blue Ash, OH 45242 Phone: 513-680-2685 | |
| Kari Leigh Batton, MOT, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4351 Sycamore Creek Dr, Blue Ash, OH 45242 Phone: 513-230-9200 | |
| Rebecca Henderson, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4440 Carver Woods Dr, Blue Ash, OH 45242 Phone: 513-791-5688 |