Individual
NANCY WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1710 W THOMPSON AVE, ENID, OK 73703-7727
(580) 242-2970
Mailing address
1710 W THOMPSON AVE, ENID, OK 73703-7727
(580) 242-2970
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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