| Doctor Name: | CASSANDRA JOAN WAGGONER |
| NPI Number: | 1215059142 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 429103 |
| Business Practice Address: | 10318 6th St S Fargo, ND - 581048116 |
| Business Phone Number: | 7012383908 |
| Business Fax Number: | 7012322330 |
| Mailing Address: | 10318 6th St S, FARGO |
| State: | ND |
| Postal Code: | 581048116 |
| Phone Number: | 7012383908 |
| Fax Number: | 7012322330 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 429103 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |