Individual
ANGELA MARIE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ALC
Contact information
Practice address
215 GRAND AVE SW, FORT PAYNE, AL 35967-1917
(256) 509-0504
Mailing address
215 GRAND AVE SW, FORT PAYNE, AL 35967-1917
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
822268
AL
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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