Individual
WANDA MARIE BOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
233 TIFFANY PARK, GAFFNEY, SC 29341
(864) 902-5073
Mailing address
PO BOX 1227, ROEBUCK, SC 29376-1227
(864) 587-8143
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2625
SC
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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