Individual
MRS. CODIE WASHBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C.
Contact information
Practice address
UWA STATION #14, LIVINGSTON, AL 35470
(205) 652-3489
Mailing address
UWA STATION #14, LIVINGSTON, AL 35470
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1550
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1550
STATE LICENSURE
AL
01
—
2000012354
BOARD OF CERTIFICATION NUMBER
AL
Enumeration date
10/26/2015
Last updated
10/26/2015
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