MR. Kenneth Ray Waggoner, LPC, LADC

NPI #1518038041 in Fort Sill, Oklahoma

Provider Information

NPI Number: 1518038041
Entity Type: Individual
Name: MR. Kenneth Ray Waggoner, LPC, LADC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: LPC, LADC
Enumeration Date: Nov 13, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 4301 MOW-WAY ROAD
City: Fort Sill
State: Oklahoma
ZIP Code: 73503-6300
Phone: (580) 458-2134

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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