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Individual

MR. LAWRENCE DRAKE WENTWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5721 MARLIN RD, STE 3100 6100 BLDG, CHATTANOOGA, TN 37411-5644
(423) 648-2340
(423) 499-9986
Mailing address
5721 MARLIN RD, STE 3100 6100 BLDG, CHATTANOOGA, TN 37411-5644
(423) 648-2340
(423) 499-9986

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
346
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3691042
TN
01
4077812
BCBS
TN
Enumeration date
08/02/2006
Last updated
07/08/2007
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