Individual
CORA DANIELLE WANDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
915 AIRPORT RD, JACKSON, MI 49202-1872
(248) 672-7244
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801093450
MI
1041C0700X
Clinical Social Worker
6801093450
MI
Other
Enumeration date
02/06/2019
Last updated
02/06/2025
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