Individual
TAMARA BENNETT WENZL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
516 WOODBERRY DR, MOORESVILLE, NC 28115-2862
(704) 606-6885
Mailing address
516 WOODBERRY DR, MOORESVILLE, NC 28115-2862
(704) 606-6885
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/19/2006
Last updated
09/07/2022
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