Individual
MS. KARI SUE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
201 KENDALL DRIVE, LAMAR, CO 81052
(719) 336-7501
(719) 336-7453
Mailing address
1801 S 10TH ST, LAMAR, CO 81052-4142
(224) 366-1517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4340
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53344
NCC
—
Enumeration date
02/28/2007
Last updated
07/08/2007
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