Individual
CARRIE WENNERDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SW
Contact information
Practice address
13101 BRUCE B DOWNS BLVD, TAMPA, FL 33612-3803
(813) 821-8038
(813) 974-4325
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118757800
—
FL
Enumeration date
03/27/2023
Last updated
08/23/2023
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