| Bonnie K Wagner, MS / CCC-SLP | |
| 
					1501 12th Ave S, Nashville, TN 37203-4909  | |
| (615) 933-0070 | |
| (615) 383-9489 | 
| Full Name | Bonnie K Wagner | 
|---|---|
| Gender | Female | 
| Speciality | Speech-language Pathologist | 
| Location | 1501 12th Ave S, Nashville, Tennessee | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1942840277 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 3246 (Tennessee) | Primary | 
| Provider Name | Select Physical Therapy Holdings Inc | 
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Provider Identifiers | NPI Number: 1619939766 PECOS PAC ID: 9537076401 Enrollment ID: O20160912002365  | 
| Provider Name | Healthpro Heritage Rehab & Fitness Llc | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1376073262 PECOS PAC ID: 6507832573 Enrollment ID: O20171003005084  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Bonnie K Wagner, MS / CCC-SLP 1501 12th Ave S, Nashville, TN 37203-4909 Ph: (615) 933-0070  | Bonnie K Wagner, MS / CCC-SLP 1501 12th Ave S, Nashville, TN 37203-4909 Ph: (615) 933-0070  | 
Miss Joann Marx, SPEECH PATHOLOGIST M Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4525 Harding Road, Nashville, TN 37205 Phone: 615-383-4141  | |
Ms. Carly Evans, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4741 Trousdale Dr, Suite 1, Nashville, TN 37220 Phone: 615-290-5397  | |
Katherine Lewton, SLP-CCC Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2601 Bransford Ave, Nashville, TN 37204 Phone: 423-622-1551  | |
Amanda Brock,  Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2601 Bransford Ave, Nashville, TN 37204 Phone: 423-622-1551 Fax: 877-856-7133  | |
Mary Alice Patton,  Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1215 21st Ave S, Suite 6209, Nashville, TN 37232 Phone: 615-936-1597  | |
Ms. Mary E Hallum, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 8044 Coley Davis Rd, Nashville, TN 37221 Phone: 615-646-4466  | |
Lakeysha Hampton, SLP-CCC Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2601 Bransford Ave, Nashville, TN 37204 Phone: 423-622-1551 Fax: 877-856-7133  |