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1861696759
ANNIE L FORMWALT
MOBILE, AL
NPI
1861696759
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: AL 504)
Enumeration Date
2007-06-13
Last Update Date
2007-07-08
Business Address
Dr. ANNIE L FORMWALT PSY.D.
PO BOX 850818
MOBILE, AL 36685-0818
Phone number: 251-776-1217
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Mailing Address
Dr. ANNIE L FORMWALT PSY.D.
7305 COTTAGE HILL RD
MOBILE, AL 36695-2829
Phone number: 251-776-1217
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