Individual
MRS. GWENDOLYN DENESE MOBLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6561 CR 476A, BUSHNELL, FL 33513-4823
(352) 793-2013
Mailing address
PO BOX 1378, BUSHNELL, FL 33513-0077
(352) 793-2013
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6926410 98
FL
Other
Enumeration date
07/16/2008
Last updated
12/07/2016
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