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General NPI Number Information
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NPI Number | 1740108109
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Entity Type | Individual
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Provider Name | FELICA WAGNER
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Gender | Female
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 1512 E 19TH ST
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City | DES MOINES
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State | IA
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Zip | 50316-2708
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Country | US
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Telephone | 303-242-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 25TH ST SE
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City | ALTOONA
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State | IA
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Zip | 50009-7830
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Country | US
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Telephone | 515-314-6044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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