KELLY JEAN WAGNER

SIOUX CITY, IA
NPI1750513727
Former NameKELLY JEAN O'CONNELL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: IA  00850)
Enumeration Date2009-08-10
Last Update Date2009-08-10
Business Address
-- KELLY JEAN WAGNER LMHC
4301 SERGEANT RD STE 203
SIOUX CITY, IA 51106-4710
Phone number: 712-276-9000
Mailing Address
-- KELLY JEAN WAGNER LMHC
230 9TH AVE N
FORT DODGE, IA 50501-2411
Phone number: 515-573-3138
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