Individual
KATHRYN J WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8TH AVE C ST, SALT LAKE CITY, UT 84143-0001
(801) 408-5584
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 442-4950
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
112725-2501
UT
Other
Enumeration date
02/01/2007
Last updated
03/18/2008
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