Individual
TEKISHA DEHAVEN WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 HOSPITAL PLZ, CLARKSBURG, WV 26301-9316
(304) 969-3100
Mailing address
52 RIVERBEND APARTMENTS RD, CLARKSBURG, WV 26301-4152
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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