Individual
ELITHA DEIDRA WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5800 W SLAUGHTER LN, AUSTIN, TX 78749-6507
(512) 301-9772
(866) 369-0549
Mailing address
5800 W SLAUGHTER LN, AUSTIN, TX 78749-6507
(512) 301-9772
(866) 369-0549
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
141287
TX
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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