Individual
DANIELLE JILLIAN WADDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2031
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2031
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
091225
IA
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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