Individual
MR. ROBERT F WAGGENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.DIV, LCSW
Contact information
Practice address
11914 JUSTICE AVE, BATON ROUGE, LA 70816-2372
(225) 291-4282
(225) 291-7133
Mailing address
11914 JUSTICE AVE, BATON ROUGE, LA 70816-2372
(225) 291-4282
(225) 291-7133
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4069
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4069
LIC CLINICAL SW
LA
01
—
6241
AMER ASS PASTORAL COUNSE
LA
Enumeration date
09/15/2006
Last updated
12/18/2020
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