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NPI Profile for JODIE WENGER in PRAIRIE VIEW, KS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI # | 1164605853 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/17/2007 | |
| Last updated | 12/17/2007 - About 18 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JODIE WENGER