Individual
DR. KAYLA M. WAGENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
6971 UNIVERSITY AVE, WINDSOR HEIGHTS, IA 50324-1540
(515) 274-8748
Mailing address
6971 UNIVERSITY AVE, WINDSOR HEIGHTS, IA 50324-1540
(515) 274-8748
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00900
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23852
WELLMARK LEGACY NUMBER
IA
01
—
250068
MIDLANDS CHOICE LEGACY
IA
Enumeration date
02/13/2007
Last updated
07/08/2016
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