Individual
LISA D WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
8096 PARK LN, YPSILANTI, MI 48198-3615
(734) 489-9395
Mailing address
8096 PARK LN, YPSILANTI, MI 48198-3615
(734) 489-9395
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
160100000X
MI
Other
Enumeration date
07/22/2016
Last updated
12/22/2020
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