Individual
GWENDOLYN MINIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
517 ENERGY CENTER BLVD STE 1303, NORTHPORT, AL 35473-5810
(205) 399-8500
Mailing address
5127 BLACKSTONE LN, NORTHPORT, AL 35473-1091
(205) 399-8500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C3614A
AL
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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