Individual
DR. KENNETH CHARLES WADUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
1700 N BROADWAY, SUITE 118, ROCHESTER, MN 55906-4144
(507) 280-0225
(507) 280-8780
Mailing address
2400 18TH AVE SW, ROCHESTER, MN 55902-1018
(507) 282-8029
(507) 280-8780
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2777
MN
Other
Enumeration date
12/17/2006
Last updated
07/08/2007
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