Individual
WANDA LYNN PRIVETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
251 SUNSET PL, GUIN, AL 35563-2239
(205) 468-3331
Mailing address
212 COUNTY RD 136, ADDISON, AL 35540
(256) 747-1719
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2664
AL
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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