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Individual

JENNA KATE WIEDERHOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1160 1ST ST NE APT 906, WASHINGTON, DC 20002-4866
(704) 774-0696
Mailing address
1160 1ST ST NE APT 906, WASHINGTON, DC 20002-4866
(704) 774-0696

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
08/07/2019
Last updated
08/07/2019
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