NPI 1104329259

Ida Rose Wadsworth, LPC

Practitioner Professional Counselor Fort Payne, AL

Practice location

Address: 206 4th St SW, Fort Payne, AL 35967-1851
Phone: (256) 304-5755

Registered specialties

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 3953 (AL)

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Registry record

NPI: 1104329259
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Mar 2018
Record last updated: 21 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.