Individual
MS. IDA M. WIEDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
S.L.P.
Contact information
Practice address
700 W 48TH ST, KANSAS CITY, MO 64112-1865
(816) 756-1403
(816) 333-2958
Mailing address
700 W 48TH ST, KANSAS CITY, MO 64112-1865
(816) 756-1403
(816) 333-2958
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
00254
MO
Other
Enumeration date
02/14/2007
Last updated
07/08/2007
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