| Doctor Name: | RONALD LEE WAGGONER |
| NPI Number: | 1154596252 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DR PSYCHOLOGY COUNSE |
| License Number: | 39000820A |
| Business Practice Address: | 635 W Utica St Waggoners Counseling Sellersburg, IN - 47172 |
| Business Phone Number: | 8122462769 |
| Business Fax Number: | 8122469971 |
| Mailing Address: | 635 W Utica St, Waggoners Counseling SELLERSBURG |
| State: | IN |
| Postal Code: | 47172 |
| Phone Number: | 8122462769 |
| Fax Number: | 8122469971 |
| NPI Enumeration Date: | 04/29/2008 |
| NPI Last Update Date: | 04/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 39000820A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |