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1891393989
ANDREW JACOB WAGONER
JEFFERSONVILLE, IN
NPI
1891393989
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: KY 3976)
Enumeration Date
2020-10-12
Last Update Date
2020-10-20
Business Address
Mr. ANDREW JACOB WAGONER LCSW
460 SPRING ST
JEFFERSONVILLE, IN 47130-3452
Phone number: 812-913-5462
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Mailing Address
Mr. ANDREW JACOB WAGONER LCSW
460 SPRING ST
JEFFERSONVILLE, IN 47130-3452
Phone number: 812-913-5462
Copy
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