MR. Kevin Dale Wagner, MSW
NPI #1215139894 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1215139894
- Entity Type
- Individual
- Name
- MR. Kevin Dale Wagner, MSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- MSW
- Enumeration Date
- Jun 5, 2007
- Last Updated
- Dec 26, 2013
Practice Location
- Address
- 1500 N WESTWOOD BLVD
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901-3318
- Phone
- (573) 778-4631
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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