Individual
CHRISTINA JO WADDUPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1000 N BROADWAY, PERU, IN 46970-1070
(765) 472-1931
(765) 472-1975
Mailing address
800 FULTON ST, LOGANSPORT, IN 46947-1577
(574) 205-2600
(574) 739-1414
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
34006433A
IN
Other
Enumeration date
05/12/2008
Last updated
01/16/2025
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