Individual
JENNIFER WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5138
(612) 439-4650
Mailing address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5138
(612) 439-4650
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-71207
MN
Other
Enumeration date
03/02/2023
Last updated
05/20/2025
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