Individual
WANDA LONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5490 BROADWAY, L3, MERRILLVILLE, IN 46410-1675
(219) 985-6170
(219) 985-6097
Mailing address
5490 BROADWAY, L3, MERRILLVILLE, IN 46410-1675
(219) 985-6170
(219) 985-6097
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
IN
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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