Individual
KELLY L WADESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
250 METROHEALTH DR, METROHEALTH MEDICAL CENTER, CLEVELAND, OH 44109-1998
(216) 778-8804
(216) 778-5560
Mailing address
250 METROHEALTH DR, METROHEALTH MEDICAL CENTER, CLEVELAND, OH 44109-1998
(216) 778-8804
(216) 778-5560
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6019
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000326700
ANTHEM
OH
05
—
2477421
—
OH
Enumeration date
07/16/2006
Last updated
07/23/2007
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