Individual
DEANNA ELIZABETH WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHCA
Contact information
Practice address
11940 CAROLINA PLACE PKWY STE 200, PINEVILLE, NC 28134-7471
(704) 541-9080
Mailing address
100 WILLOW RUN DR APT 10, GASTONIA, NC 28056-9287
(828) 430-1437
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A20785
NC
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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