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WANDA DENISE VANN

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1891092441

Individual Registrant:
 WANDA DENISE VANN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
12816 KINGS LAKE DRIVE  GIBSONTON, FL 33534-3907 US
Tel: 813-735-0059  Fax: 813-374-3957

Contact information for business:
12816 KINGS LAKE DRIVE  GIBSONTON, FL 33534-3907 US
Tel: 813-735-0059  Fax: 813-374-3957

Registration Information:
NPI: 1891092441
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101Y00000XBehavioral Health & Social Service Providers
Counselor
Y103K00000X

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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