Individual
WANDA FAYE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
235500000X
Speech/Language/Hearing Specialist/Technologist
—
—
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
314000000X
Skilled Nursing Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
Update your record
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