Organization
STEPHANIE WENTWORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WENTWORTH (OWNER)
(813) 391-3495
Entity
Organization
Contact information
Practice address
1219 MILLENNIUM PKWY, SUITE 116, BRANDON, FL 33511-3879
(813) 391-3495
Mailing address
1219 MILLENNIUM PKWY, SUITE 116, BRANDON, FL 33511-3879
(813) 391-3495
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT3180
FL
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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