Waggoner, Timothy Ray

Waggoner, Timothy Ray is an individual health care provider with primary practice located at 12725 Race Track Rd Bldg 5 , Westchase FL 33626-1314. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Waggoner, Timothy Ray can be contacted via phone (813) 422-6431.

Contact Information

Primary practice address
12725 Race Track Rd Bldg 5 Westchase FL 33626-1314
Phone: (813) 422-6431
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1922762202
LBN Legal business name Waggoner, Timothy Ray
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2021
Last updated Oct 24th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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