Organization Name: | WADLE & ASSOCIATES PC |
NPI Number: | 1073547394 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES V WADLE (PRESIDENT) |
Mailing Address: | 2327 70th Urbandale |
State: | IA US |
Postal Code: | 50322 |
Phone Number: | 5152701344 |
Fax Number: | 5152706515 |
NPI Enumeration Date: | 07/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |