Individual
RAYMOND DALE WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., LPC
Contact information
Practice address
6815 ISAACS ORCHARD RD, SPRINGDALE, AR 72762-6324
(479) 301-6227
Mailing address
3515 PASOFINO LOOP, SPRINGDALE, AR 72764-1767
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P2310007
AR
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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