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Individual

MS. PEGGY R. SELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.B.S.W.

Contact information

Practice address
3074 10TH AVE N, FORT DODGE, IA 50501-2938
(515) 576-1643
Mailing address
3074 10TH AVE N, FORT DODGE, IA 50501-2938
(515) 576-1643

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
04800
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1010306
IA
Enumeration date
03/01/2007
Last updated
07/09/2007
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