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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. LARRY D WAGONER, PH.D., LMFT

Active Sole Proprietor

DR. LARRY D WAGONER, PH.D., LMFT is a Marriage & Family Therapist healthcare provider located in JACKSONVILLE, Florida. NPI 1417046699 is currently active in the NPPES registry. Verify at CMS.

Marriage & Family Therapist · JACKSONVILLE, FL

Registration Details

NPI Number
1417046699
Provider Type
Individual
Gender
Male
NPI Issued
Oct 12, 2006 (19.813218053875 yrs)
Last Updated
Jan 29, 2013
License
MT1162 (FL)
Sole Proprietor
Yes

Practice Information

Address
7545 CENTURION PKWY
SUITE # 105
JACKSONVILLE, FL, 322560579
Browse FL providers · Browse ZIP 32256
Phone
9046422468
Fax
9046422469
Primary Specialty
Marriage & Family Therapist
106H00000X

Other Marriage & Family Therapist Providers in JACKSONVILLE, FL

Name Credential NPI
MR. DANNY L RANDOLPH LMFT 1790787281
JENNIFER L GLOCK LMFT 1225019680
MR. CHARLES VAUGHN KEREKES LMFT, LMHC, CAP 1740210574
BRETT LOWELL RHODEN MA 1770517989
LUANN M EDWARDS LCSW 1225051832
MR. ROBERT EDWARD WILDER JR. M.DIV., M.ED. 1710999537
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.