Individual
HEIDI WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4400 W 69TH ST, SIOUX FALLS, SD 57108-8170
(605) 322-4065
(605) 322-4060
Mailing address
4400 W 69TH ST, SIOUX FALLS, SD 57108-8170
(605) 322-4065
(605) 322-4060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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