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Michael Waggoner
Peer Specialist in Kenova, West Virginia
NPI 1285408492

Michael Waggoner is a Peer Specialist based in Barboursville, WV. Michael Waggoner practices in Kenova, WV. The NPI Number for Michael Waggoner is 1285408492 and holds a License No. (West Virginia).

The current practice location address for Michael Waggoner is 802 Oak St, Kenova, WV and can be reached out via phone at 304-939-6901.

Location: 802 Oak St, Kenova, WV, 25504-1141
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285408492
Provider Name
Michael Waggoner
Credential
Provider Entity Type
Individual
Gender
Male
Address
802 Oak St, Kenova, WV, 25504-1141
Phone Number
304-939-6901
Fax Number
Provider Enumeration Date
11/08/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
802 Oak St
City
Kenova
State
West Virginia
Zip
25530-1519
Phone Number
304-939-6901
Fax Number
person
Provider Business Mailing Address Details
Address
802 Oak St
City
Kenova
State
West Virginia
Zip
25530-1519
Phone Number
304-939-6901
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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