Individual
MOLLY ELIZABETH WADDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 E CLARK ST LOT 22, LA PLATA, MO 63549-1378
(660) 651-6242
Mailing address
620 E CLARK ST LOT 22, LA PLATA, MO 63549-1378
(660) 651-6242
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
485299
MO
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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