# GARRETT WAGGONER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801543020
- **Gender:** Man
- **Credential:** RBT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106S00000X | Behavior Technician | RBT-22-206195 | CO | Yes |

## Other

- **Enumeration date:** 03/08/2022
- **Last updated:** 02/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1790211605 | — | CO |