LARRY D WAGONER

JACKSONVILLE, FL
NPI1417046699
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: FL  MT1162)
Enumeration Date2006-10-12
Last Update Date2013-01-29
Business Address
Dr. LARRY D WAGONER Ph.D., LMFT
7545 CENTURION PKWY SUITE # 105
JACKSONVILLE, FL 32256-0579
Phone number: 904-642-2468
Mailing Address
Dr. LARRY D WAGONER Ph.D., LMFT
2058 BEACH AVE
ATLANTIC BEACH, FL 32233-5935
Phone number: 904-372-7365
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