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Individual

KIMBERLY M. WARDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
2522 E. 70TH STREET, SHREVEPORT, LA 71105
(318) 795-3388
Mailing address
2522 E. 70TH STREET, SHREVEPORT, LA 71105

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
R-20957
LA
235Z00000X
Speech-Language Pathologist
Primary
3893
LA

Other

Enumeration date
02/14/2007
Last updated
01/23/2025
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