Individual
LEIGH ELIZABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
3901 RAINBOW BLVD, MAILSTOP 1017, KANSAS CITY, KS 66103-2937
(913) 588-6208
Mailing address
11754 GARNETT ST, OVERLAND PARK, KS 66210-3449
(402) 202-2494
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1586
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1586
REGISTERED DIETITIAN
KS
Enumeration date
05/28/2010
Last updated
05/28/2010
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