Provider Demographics
NPI:1760989685
Name:WADUD, MICHELE (MSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:WADUD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 CRESTMONT DR
Mailing Address - Street 2:
Mailing Address - City:NEWFOUNDLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18445-5202
Mailing Address - Country:US
Mailing Address - Phone:570-252-4417
Mailing Address - Fax:
Practice Address - Street 1:10 BUIST RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-9311
Practice Address - Country:US
Practice Address - Phone:570-296-1138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker