Individual
MS. HEATHER LYNNE WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISWS
Contact information
Practice address
600 WAYNE AVENUE, DAYTON, OH 45410
(937) 496-2000
(937) 463-2901
Mailing address
600 WAYNE AVENUE, DAYTON, OH 45410
(937) 496-2000
(937) 463-2901
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I0007672S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000003211683
ANTHEM BCBS
OH
Enumeration date
03/19/2008
Last updated
03/19/2008
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