Kenneth Charles Wadum in Rochester - Clinical
Kenneth Charles Wadum - NPI 1225191976
Kenneth Charles Wadum is a Clinical in Rochester, Minnesota. Kenneth Charles Wadum practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth Charles Wadum is 1225191976. The last update date is 2007-07-08.
Kenneth Charles Wadum's current location address is 2400 18th Ave Sw, Rochester, Minnesota. You can contact this provider via phone number 5072828029 and fax number 5072808780. The mailing address for Kenneth Charles Wadum is 2400 18th Ave Sw, Rochester, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Charles Wadum |
|---|---|
| Address | 2400 18th Ave Sw, Rochester, Minnesota |
| Phone Number | 5072828029 |
| Fax Number | 5072808780 |
| Sole Proprietor | Y |
| Credentials | ED.D. |
NPI Number Detail
| NPI Number | 1225191976 |
|---|---|
| Provider Enumeration Date | 2006-12-17 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2400 18th Ave Sw |
|---|---|
| City | Rochester |
| State | Minnesota (MN) |
| Post Code | 559021018 |
| Phone Number | 5072828029 |
| Fax Number | 5072808780 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | LP2777 |
|
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
|
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Kenneth Charles Wadum by the Centers for Medicare & Medicaid Services?
The Kenneth Charles Wadum has been issued the NPI (National Provider Identifier) 1225191976, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Kenneth Charles Wadum?
The Kenneth Charles Wadum is physically situated at 2400 18Th Ave Sw, in the city of Rochester, state of MN, with the postal code 559021018.
What is the Kenneth Charles Wadum's specialty and taxonomy code?
The Kenneth Charles Wadum's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1225191976 to Kenneth Charles Wadum?
The Centers for Medicare & Medicaid Services originally issued the 1225191976 to Kenneth Charles Wadum on 2006-12-17.
When was the information related to Kenneth Charles Wadum most recently updated or refreshed?
The details pertaining to the Kenneth Charles Wadum, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.
Address: Po Box 2333, Clay, NY
Address: 850 N Harrison St, Warsaw, IN
Address: 1143 Deer Trail Ln, Solvang, CA
Address: 7840 Oracle Pl, Potomac, MD
Address: Po Box 1289, Tampa, FL
Address: 727 N Waco Ave, Wichita, KS
Address: 1115 Elkton Dr, Colorado Springs, CO
Address: 501 S Washington St, Swayzee, IN
Address: 1709 Colley Ave, Norfolk, VA
Address: 3500 Depauw Blvd Ste 3070, Indianapolis, IN
Address: 54045 Ridge Rd, Yucca Valley, CA
Address: 7600 Osler Dr, Towson, MD
Address: 3000 Citrus Cir, Walnut Creek, CA
Address: 41 Park Ave, New York, NY
Address: 1935 County Road B2 W Ste 270, Roseville, MN