Individual
HALEY ALYNN WAGONBLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5001 COLLEGE BLVD STE 105, LEAWOOD, KS 66211-1618
(913) 257-3161
Mailing address
7604 EICHER DR, SHAWNEE, KS 66217-3004
(716) 830-6258
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC03956
KS
101YP2500X
Professional Counselor
Primary
03870
KS
Other
Enumeration date
08/18/2021
Last updated
11/18/2024
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