Organization
KEN WADUM, ED.D. LP
Active
Parent organization
KEN WADUM, ED.D., LP
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEN WADUM, ED.D., LP
Authorized official
DR. KENNETH CHARLES WADUM ED.D. (OWNER)
(507) 280-0225
Entity
Organization
Contact information
Practice address
1530 GREENVIEW DR SW, SUITE 207, ROCHESTER, MN 55902-4286
(507) 280-0225
Mailing address
1530 GREENVIEW DR SW, SUITE 207, ROCHESTER, MN 55902-4286
(507) 280-0225
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2777
MN
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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