Individual
KELLI WEGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3305 ASHLAR PT APT 304, LADSON, SC 29456-4277
(518) 522-4296
Mailing address
3305 ASHLAR PT APT 304, LADSON, SC 29456-4277
(518) 522-4296
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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