Organization
MAGNOLIA BEHAVIORAL HEALTH, PLLC
Active
Other names
Magnolia Psychiatry and Mental Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE WENZEL PMHNP-BC (CEO/OWNER)
(919) 961-1948
Entity
Organization
Contact information
Practice address
602 E ACADEMY ST STE 205, FUQUAY VARINA, NC 27526-2382
(919) 635-6202
(919) 289-1713
Mailing address
602 E ACADEMY ST STE 205, FUQUAY VARINA, NC 27526-2382
(919) 635-6202
(919) 289-1713
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
174400000X
Specialist
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
405300000X
Prevention Professional
Primary
—
—
Other
Enumeration date
08/17/2023
Last updated
03/08/2024
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