Individual
MRS. WANDA GERALDINEA LAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
704 HIGHWAY 100 STE 101, CENTERVILLE, TN 37033-1172
(931) 729-3573
Mailing address
9336 BIG SPRING CREEK RD, BON AQUA, TN 37025-2802
(931) 670-9988
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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