Individual
MS. JILL DEGLER WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
108 N MAIN ST STE 305, SOUTH BEND, IN 46601-1614
(574) 234-3515
(574) 234-3565
Mailing address
1601 BYRON DR, SOUTH BEND, IN 46614-2804
(574) 291-2971
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001091A
IN
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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