Individual
MRS. KIMBERLY SUE WAGGY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA;EDS
Contact information
Practice address
408 EB SAUNDERS WAY, CLARKSBURG, WV 26301
(304) 624-6554
(304) 624-5223
Mailing address
PO BOX 1370, CLARKSBURG, WV 26302-1370
(304) 624-6554
(304) 624-5223
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1304
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810013188
—
WV
Enumeration date
10/07/2008
Last updated
10/07/2008
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