Individual
MR. WENDELL ELLIOTT GAILLARD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
1819 PEPPERELL PKWY, SUITE 210, OPELIKA, AL 36801-5475
(334) 741-9952
Mailing address
2177 JEFFERSON ST, AUBURN, AL 36830-6601
(334) 887-8222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2201
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2201
ALABAMA BOARD CERTIFICATI
AL
Enumeration date
12/15/2006
Last updated
07/08/2007
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