Individual
MISS JENNIFER MARIE WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C8432 LCSW
Contact information
Practice address
7714 MOANALUA WAY, DIAMONDHEAD, MS 39525-3740
(228) 305-0063
Mailing address
7714 MOANALUA WAY, DIAMONDHEAD, MS 39525-3740
(228) 305-0063
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C8432
MS
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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