Individual
MS. ELIZABETH WELDER WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.I.S.W.
Contact information
Practice address
3600 LINCOLN WAY, SUITE 4, AMES, IA 50014-7595
(515) 239-4410
(515) 663-4885
Mailing address
1217 K AVE, NEVADA, IA 50201-1943
(515) 382-4099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
04701
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36323
BLUE SHIELD OF IOWA
IA
Enumeration date
01/16/2006
Last updated
07/08/2007
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