Individual
JODIE WENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
314 MAYBERRY LANE, PRAIRIE VIEW, KS 67664
(785) 973-2364
Mailing address
314 MAYBERRY LANE, PRAIRIE VIEW, KS 67664
(785) 973-2364
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
1866
KS
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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