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1376305409
BRIAN WAGGONER
ROGERS, AR
NPI
1376305409
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AR A2401024)
Enumeration Date
2024-01-24
Last Update Date
2024-01-26
Business Address
Mr. BRIAN WAGGONER LAC, NCC
5310 W VILLAGE PKWY STE 4
ROGERS, AR 72758-8201
Phone number: 479-435-8388
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Mailing Address
Mr. BRIAN WAGGONER LAC, NCC
19369 NEILLS BLUFF RD
SPRINGDALE, AR 72764-8503
Phone number: 630-740-7705
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