Individual
DR. JOHN WESLEY WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-0385
Mailing address
301 FISHER ST, KEESLER AFB, MS 39534-2508
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
601056
MS
Other
Enumeration date
12/19/2006
Last updated
05/24/2022
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