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Individual

MRS. SELENE SOPHIA WADDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MC,LPC

Contact information

Practice address
990 VILLA ST, MOUNTAIN VIEW, CA 94041-1236
(888) 688-9296
Mailing address
4118 E 2ND ST, TUCSON, AZ 85711-1014
(520) 795-3432

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-2137
AZ

Other

Enumeration date
01/12/2021
Last updated
01/25/2021
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