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Organization
WARDELL INTEREST, INC.
Active
Organization
WARDELL INTEREST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WARDELL (OWNER)
(318) 795-3388
Entity
Organization
Contact information
Practice address
2522 EAST 70TH STREET, SHREVEPORT, LA 71105-4002
(318) 795-3388
Mailing address
2522 EAST 70TH STREET, SHREVEPORT, LA 71105-4002
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6731
LA
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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