MR. Grant Jordan Waggoner, LMFT

NPI #1346911450 in Dana Point, California

Provider Information

NPI Number: 1346911450
Entity Type: Individual
Name: MR. Grant Jordan Waggoner, LMFT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: LMFT
Enumeration Date: Sep 28, 2021
Last Updated: Sep 28, 2021

Practice Location

Address: 24632 SAN JUAN AVE STE 110
City: Dana Point
State: California
ZIP Code: 92629-3830
Phone: (702) 533-8324

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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