Individual
ADDISON JADE WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
421 WINDCHIME PL, COLORADO SPRINGS, CO 80919-1984
(888) 754-0398
Mailing address
1055 BRANTLEY HEIGHTS MAILROOM #236, COLORADO SPRINGS, CO 80907
(620) 640-9758
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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