Individual
MRS. MARY S WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4500 I 55 N, SUITE 291, JACKSON, MS 39211-5930
(601) 362-0859
Mailing address
1600 LINDEN PL, JACKSON, MS 39202-1215
(601) 355-4653
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2782
MS
Other
Enumeration date
11/05/2006
Last updated
07/08/2007
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