Individual
KRISTEN WAGHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2315 CENTRAL AVE STE C, AUGUSTA, GA 30904-6246
(706) 364-6712
(706) 364-6172
Mailing address
2315 CENTRAL AVE STE C, AUGUSTA, GA 30904-6246
(706) 364-6712
(706) 364-6172
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006250
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
673942428C
—
GA
Enumeration date
08/05/2007
Last updated
08/05/2007
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