# STEPHANIE WENTWORTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063951309
- **Authorized official:** STEPHANIE WENTWORTH (OWNER)
- **Authorized official phone:** (813) 391-3495

## Contact information

- **Practice address:** 1219 MILLENNIUM PKWY, SUITE 116, BRANDON, FL 33511-3879
- **Practice address phone:** (813) 391-3495
- **Mailing address:** 1219 MILLENNIUM PKWY, SUITE 116, BRANDON, FL 33511-3879
- **Mailing address phone:** (813) 391-3495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MT3180 | FL | Yes |

## Other

- **Enumeration date:** 02/20/2017
- **Last updated:** 02/20/2017