Individual
MRS. CHARNELL MARIE WIDNALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC
Contact information
Practice address
4100 W KENNEDY BLVD STE 214, TAMPA, FL 33609-2244
(813) 553-7910
Mailing address
3118 W BARCELONA ST, TAMPA, FL 33629-7210
(813) 420-8256
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH18278
FL
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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