Provider Demographics
NPI:1639042856
Name:SADDLER, WANESSA WENEE
Entity type:Individual
Prefix:
First Name:WANESSA
Middle Name:WENEE
Last Name:SADDLER
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 1:12613 SOBIESKI AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-4865
Mailing Address - Country:US
Mailing Address - Phone:216-971-4740
Mailing Address - Fax:
Practice Address - Street 1:12613 SOBIESKI AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-4865
Practice Address - Country:US
Practice Address - Phone:216-971-4740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor