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.
Location: 57 Dora Ln, Greenup, KY, 41105-0790
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
Provider Business Practice Location Address Details
Address
57 Dora Ln
City
State
Zip
41144-1187
Phone Number
606-473-7333
Fax Number
Provider Business Mailing Address Details
Address
57 Dora Ln
City
State
Zip
41144-1187
Phone Number
606-473-7333
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
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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