Individual
MR. RICHARD S WAGUESPACK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BTH, LCSW
Contact information
Practice address
603 W GARY BLVD, CLINTON, OK 73601-2715
(580) 500-8050
(888) 344-9087
Mailing address
303 N MARKET ST, CORDELL, OK 73632-4229
(580) 500-8050
(888) 344-9087
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4389
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200506970-A
—
OK
Enumeration date
06/20/2012
Last updated
09/12/2025
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