Individual
MISS GWENDOLYN WORSHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
893 HIGHWAY 64, AUGUSTA, AR 72006-5119
(870) 347-5906
(870) 347-1457
Mailing address
1101 WOODRUFF, AUGUSTA, AR 72006
(870) 347-1436
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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