Individual
THERESA WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MS, CADC, MFTA
Contact information
Practice address
400 RING RD STE 155, ELIZABETHTOWN, KY 42701-8790
(844) 473-6378
Mailing address
400 RING RD STE 155, ELIZABETHTOWN, KY 42701-8790
(844) 473-6378
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
118429
KY
106H00000X
Marriage & Family Therapist
298308
KY
Other
Enumeration date
10/15/2015
Last updated
10/20/2025
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