Individual
KELLY J WEDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
925 S LINCOLN BLVD, HODGENVILLE, KY 42748-1701
(844) 435-0900
(270) 858-4029
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4607
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
276325
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15540976
CAQH
KY
05
—
7100811660
—
KY
Enumeration date
04/26/2010
Last updated
09/01/2023
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