Individual
WANDA GOTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
808 LAY DAM RD, CLANTON, AL 35045-2943
(205) 280-7733
Mailing address
275 COUNTY ROAD 124, JEMISON, AL 35085-4025
(205) 955-0009
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3499
AL
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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