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Kosha Wagoner
Peer Specialist in Greenup, Kentucky
NPI 1306591458

Kosha Wagoner is a Peer Specialist based in Ashland, KY. Kosha Wagoner practices in Greenup, KY. The NPI Number for Kosha Wagoner is 1306591458 and holds a License No. (Kentucky).

The current practice location address for Kosha Wagoner is 57 Dora Ln, Greenup, KY and can be reached out via phone at 606-473-7333. You can also correspond with Kosha Wagoner through the mailing address at PO BOX 790, ASHLAND, KY - 41105-0790 (mailing address contact number: ).

Location: 57 Dora Ln, Greenup, KY, 41105-0790
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306591458
Provider Name
Kosha Wagoner
Credential
Provider Entity Type
Individual
Gender
Female
Address
57 Dora Ln, Greenup, KY, 41105-0790
Phone Number
606-473-7333
Fax Number
Provider Enumeration Date
02/17/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
57 Dora Ln
City
Greenup
State
Kentucky
Zip
41144-1187
Phone Number
606-473-7333
Fax Number
person
Provider Business Mailing Address Details
Address
57 Dora Ln
City
Greenup
State
Kentucky
Zip
41144-1187
Phone Number
606-473-7333
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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