Individual
AMANDA WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8320 MADISON AVE, INDIANAPOLIS, IN 46227-6066
(317) 882-5122
(317) 888-8642
Mailing address
8320 MADISON AVE, INDIANAPOLIS, IN 46227-6066
(317) 882-5122
(317) 888-8642
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33006650A
IN
Other
Enumeration date
08/21/2014
Last updated
11/05/2014
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