GARY WAGONER NPI 1144327610

NPI Information

Gary Wagoner is a counselor in Greenup, KY. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Gary Wagoner NPI is 1144327610. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

57 DORA LANE
GREENUP, KY
ZIP 41144
Phone: (606) 473-7333
Fax: (606) 473-7335

The enumeration date for this NPI number is 9/19/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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