Provider Demographics
NPI:1245461730
Name:WADDELL, CALANDRA L
Entity type:Individual
Prefix:MRS
First Name:CALANDRA
Middle Name:L
Last Name:WADDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-0244
Mailing Address - Country:US
Mailing Address - Phone:919-361-1090
Mailing Address - Fax:919-361-9922
Practice Address - Street 1:200 MEREDITH DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2287
Practice Address - Country:US
Practice Address - Phone:919-361-1090
Practice Address - Fax:919-361-9922
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist