Individual
MRS. JACLYN WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1040 W ANTELOPE CREEK WAY, TUCSON, AZ 85737-6645
(520) 389-2718
Mailing address
1040 W ANTELOPE CREEK WAY, TUCSON, AZ 85737-6645
(520) 389-2718
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
329706
AZ
Other
Enumeration date
01/09/2024
Last updated
01/24/2024
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