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General NPI Number Information
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NPI Number | 1508628991
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Entity Type | Individual
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Provider Name | MELISSA WADLINGTON
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Gender | Female
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Dates
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Enumeration Date | 01/30/2024
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 624 MARKET AVE N
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City | CANTON
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State | OH
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Zip | 44702-1017
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Country | US
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Telephone | 330-338-6049
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Fax |
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Provider Business Mailing Address
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Address Line | 9486A CLEVELAND AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-4520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | APS.004729
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License Number State | OH
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