Individual provider · Type 1 NPI

Jacob Waggoner

Professional Counselor · Chicago, IL

NPI number 1619790003 Active

Practice location

2043 W Belmont Ave Ste 1
Chicago, IL 60618-6796

Call (312) 324-4502 Map

Mailing address

1344 W Lunt Ave Apt 303
Chicago, IL 60626-3072

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1619790003

Jacob Waggoner's National Provider Identifier is 1619790003, issued on Nov 4, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Nov 4, 2024.