Provider Demographics
NPI:1891119228
Name:FLOYD-STROTHERS, WANDA
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:FLOYD-STROTHERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 ORIOLE BLVD
Mailing Address - Street 2:102
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3500
Mailing Address - Country:US
Mailing Address - Phone:972-708-9191
Mailing Address - Fax:972-708-9292
Practice Address - Street 1:606 ORIOLE BLVD
Practice Address - Street 2:102
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3500
Practice Address - Country:US
Practice Address - Phone:972-708-9191
Practice Address - Fax:972-708-9292
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2093104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker