Individual
RENEE ANN FAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1551 INDIAN HILLS DR, SIOUX CITY, IA 51104-1859
(712) 258-4700
(712) 258-4777
Mailing address
200 E ASH ST, CLEGHORN, IA 51014-7724
(515) 418-7717
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
088631
IA
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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