person
Mrs. Kathleen A Waggoner, LPC
Professional Counselor in Farmington, Missouri
NPI 1609971886

Kathleen A Waggoner is a Professional Counselor based in Sedgewickville, MO and is specialized in Professional. Kathleen A Waggoner practices in Farmington, MO and has the professional credentials of LPC. The NPI Number for Kathleen A Waggoner is 1609971886 and holds a License No. 2004014231 (Missouri).

The current practice location address for Kathleen A Waggoner is 400 N Washington St Ste 111, Farmington, MO and can be reached out via phone at 573-664-1117 and via fax at 573-664-1117. You can also correspond with Kathleen A Waggoner through the mailing address at RR 2 BOX 2335, SEDGEWICKVILLE, MO - 63781-9706 (mailing address contact number: 573-576-1936).

Location: 400 N Washington St Ste 111, Farmington, MO, 63781-9706
person
Provider Profile Details
NPI Number
1609971886
Provider Name
Kathleen A Waggoner
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
400 N Washington St Ste 111, Farmington, MO, 63781-9706
Phone Number
573-664-1117
Fax Number
573-664-1117
Provider Enumeration Date
09/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
202194 01 MO BLUE CROSS BLUE SHIELD
738553 01 MO HEALTHLINK
499297703 05 MO
431344414WAG 01 MO UNITY MANAGED MENTAL HEAL
institution
Provider Business Practice Location Address Details
Address
400 N Washington St Ste 111
City
State
Zip
63640-1731
Phone Number
573-664-1117
Fax Number
573-664-1117
person
Provider Business Mailing Address Details
Address
400 N Washington St Ste 111
City
State
Zip
63640-1731
Phone Number
573-664-1117
Fax Number
573-664-1117
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
2004014231 (Missouri)
Definition
Definition to come...
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