Individual
JODI LORENE WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
124 GRAYSIDE AVE, MAUSTON, WI 53948-1913
(608) 847-7575
(608) 847-3096
Mailing address
S6908 MISSEL RD, DE SOTO, WI 54624-6350
(608) 790-1967
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
12209-125
WI
Other
Enumeration date
09/07/2021
Last updated
01/23/2026
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