DR. Kelly Condon Waggoner, PSY.D.
NPI #1275867418 in Hermosa Beach, California
Provider Information
- NPI Number
- 1275867418
- Entity Type
- Individual
- Name
- DR. Kelly Condon Waggoner, PSY.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - Clinical
- Credential
- PSY.D.
- Enumeration Date
- Sep 21, 2009
- Last Updated
- Sep 29, 2011
Practice Location
- Address
- 2200 PACIFIC COAST HWY STE 215
- City
- Hermosa Beach
- State
- California
- ZIP Code
- 90254-2701
- Phone
- (310) 567-0456
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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