Individual
MR. EDDIE L WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LCSW
Contact information
Practice address
804 PECAN GROVE RD E, SHERMAN, TX 75090-1767
(903) 893-7768
(903) 893-4979
Mailing address
804 PECAN GROVE RD E, SHERMAN, TX 75090-1767
(903) 893-7768
(903) 893-4979
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
01315
TX
1041C0700X
Clinical Social Worker
Primary
10473
TX
Other
Enumeration date
12/03/2007
Last updated
12/03/2007
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