institution
Phil Waggoner
Addiction (Substance Use Disorder) Counselor in Lewiston, Idaho
NPI 1871651422

Phil Waggoner is an Addiction (Substance Use Disorder) Counselor based in Lewiston, ID and is specialized in Addiction (Substance Use Disorder). Phil Waggoner practices in Lewiston, ID. The NPI Number for Phil Waggoner is 1871651422 and holds a License No. 138 (Idaho).

The current practice location address for Phil Waggoner is 1720 18Th Ave, Lewiston, ID and can be reached out via phone at 208-746-4097 and via fax at 208-746-2294.

Location: 1720 18Th Ave, Lewiston, ID, 83501
institution
Provider Profile Details
NPI Number
1871651422
Provider Name
Phil Waggoner
Credential
Provider Entity Type
Organization
Address
1720 18Th Ave, Lewiston, ID, 83501
Phone Number
208-746-4097
Fax Number
208-746-2294
Provider Enumeration Date
12/05/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1720 18Th Ave
City
State
Zip
83501-4047
Phone Number
208-746-4097
Fax Number
208-746-2294
person
Provider Business Mailing Address Details
Address
1720 18Th Ave
City
State
Zip
83501-4047
Phone Number
208-746-4097
Fax Number
208-746-2294
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
138 (Idaho)
Definition
Definition to come...
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