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Individual

LINDA K WAGGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
493 EASTLAND, TWIN FALLS, ID 83303-0047
(208) 732-0995
(208) 732-0993
Mailing address
4265 NORTH 1400 EAST, BUHL, ID 83316
(208) 490-0800

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC203
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805997100
ID
Enumeration date
02/20/2009
Last updated
02/20/2009
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