Provider Information for 1942778733
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WHITNEY WANDERSCHEID LPC-MH30643
Sex: Female
NPI: 1942778733
Last Updated: 2024-01-03
Certification Date: 2024-01-03
Certification Date: 2024-01-03
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1942778733 | ||||||||
| Enumeration Date | 2018-11-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 135 SERGEANT BLUFF, IA 51054-0135 United States Phone: 712-253-7174 | Fax: | ||||||||
| Primary Practice Address | 211 5TH ST SERGEANT BLUFF, IA 51054-8510 United States Phone: 712-253-7174 | Fax: | ||||||||
| Secondary Practice Address(es) | 5032 S BUR OAK PL STE 217 | ||||||||
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