Individual
CHRISTIAN ONEAL WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
YPSS CERTIFED
Contact information
Practice address
1620 KENTUCKY AVE, PADUCAH, KY 42003-2851
(270) 442-7121
(270) 443-9692
Mailing address
425 BROADWAY ST STE 201, PADUCAH, KY 42001-0713
(270) 442-7121
(270) 443-9692
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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