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1245352855
KIMBERLY WAGNER
BLOOMINGTON, IN
NPI
1245352855
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC1900X Psychologist, Counseling
(Licence: IN 20042059A)
Enumeration Date
2007-04-04
Last Update Date
2007-07-08
Business Address
Dr. KIMBERLY WAGNER Ph.D.
201 N ROSE AVE ROOM 32
BLOOMINGTON, IN 47405-1005
Phone number: 812-856-8572
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Mailing Address
Dr. KIMBERLY WAGNER Ph.D.
2401 E 8TH ST
BLOOMINGTON, IN 47408-4212
Phone number:
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