Individual
SANDRA WENCLASKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3604 WINIFRED DR, FORT WORTH, TX 76133-2127
(817) 296-1388
Mailing address
3604 WINIFRED DR, FORT WORTH, TX 76133-2127
(817) 296-1388
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11917
TX
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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