KELLY ANNE WAGNER

WEISER, ID
NPI1235562307
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: ID  TSLP-2301)
Enumeration Date2013-08-13
Last Update Date2013-08-13
Business Address
Mrs. KELLY ANNE WAGNER SLP
331 E PARK ST
WEISER, ID 83672-2053
Phone number: 208-549-0206
Mailing Address
Mrs. KELLY ANNE WAGNER SLP
331 E PARK ST
WEISER, ID 83672-2053
Phone number: 208-890-2995
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