KENNETH RAY WAGGONER

FORT SILL, OK
NPI1518038041
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK  415)
Enumeration Date2006-11-13
Last Update Date2007-07-08
Business Address
Mr. KENNETH RAY WAGGONER LPC, LADC
4301 MOW-WAY ROAD
FORT SILL, OK 73503-6300
Phone number: 580-458-2134
Mailing Address
Mr. KENNETH RAY WAGGONER LPC, LADC
2103 NW 55TH ST
LAWTON, OK 73505-3117
Phone number: 580-248-5425
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