Provider Demographics
NPI:1417739756
Name:WOLFENDEN, ARDEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ARDEN
Middle Name:
Last Name:WOLFENDEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 REDPATH ST
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-3737
Mailing Address - Country:US
Mailing Address - Phone:360-501-1700
Mailing Address - Fax:
Practice Address - Street 1:500 REDPATH ST
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-3737
Practice Address - Country:US
Practice Address - Phone:360-501-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61487574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist