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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ILSE WAGENBACH

Active Sole Proprietor

ILSE WAGENBACH is a Pediatric Occupational Therapist healthcare provider located in BUTLER, Tennessee. NPI 1740155522 is currently active in the NPPES registry. Verify at CMS.

Pediatric Occupational Therapist · BUTLER, TN

Registration Details

NPI Number
1740155522
Provider Type
Individual
Gender
Female
NPI Issued
Oct 9, 2025 (0.84823518929053 yrs)
Last Updated
Oct 9, 2025
Sole Proprietor
Yes

Practice Information

Address
13147 HIGHWAY 67 W
BUTLER, TN, 376407218
Browse TN providers · Browse ZIP 37640
Phone
4236090133
Primary Specialty
Pediatric Occupational Therapist
225XP0200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.