| Ken Wadum, Ed.d. Lp | |
|
1530 Greenview Dr Sw Suite 207 Rochester MN 55902-4286 | |
| (507) 280-0225 | |
| Not Available |
| Full Name | Ken Wadum, Ed.d. Lp |
|---|---|
| Speciality | Psychologist |
| Location | 1530 Greenview Dr Sw, Rochester, Minnesota |
| Authorized Official Name and Position | Kenneth Charles Wadum (OWNER) |
| Authorized Official Contact | 5072800225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ken Wadum, Ed.d. Lp 1530 Greenview Dr Sw Suite 207 Rochester MN 55902-4286 Ph: (507) 280-0225 | Ken Wadum, Ed.d. Lp 1530 Greenview Dr Sw Suite 207 Rochester MN 55902-4286 Ph: (507) 280-0225 |
| NPI Number | 1043561335 |
|---|---|
| Provider Enumeration Date | 09/26/2012 |
| Last Update Date | 09/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043561335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP2777 (Minnesota) | Primary |
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