Individual
KRISTINE EDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4120
(715) 847-2600
(715) 847-2626
Mailing address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
746
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42701700
—
WI
Enumeration date
08/21/2006
Last updated
04/24/2009
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