Provider Demographics
NPI:1710381975
Name:WAGGONER, APRIL M
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:M
Last Name:WAGGONER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:M
Other - Last Name:VANDEVENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:358 S. OAKDALE
Mailing Address - Street 2:FAMILY SOLUTIONS
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501
Mailing Address - Country:US
Mailing Address - Phone:541-776-5793
Mailing Address - Fax:541-776-5798
Practice Address - Street 1:358 S. OAKDALE
Practice Address - Street 2:FAMILY SOLUTIONS
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501
Practice Address - Country:US
Practice Address - Phone:541-776-5793
Practice Address - Fax:541-776-5798
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst