Jodi Waddell

NPI 1972272755 · on the registry since 2021 · sole proprietor

Practice

Address: 124 Grayside Ave
Mauston, WI 53948
Phone: (608) 847-7575
Fax: (608) 847-3096
Organisation at this address: Pine Valley Residential Services
Pine Valley Integrated Services Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 13

Registry record

Primary taxonomy: 101YP2500X
101YP2500X
Licence states on file: WI
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2026-01-23

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin