Healthcare Provider Details

I. General information

NPI: 1750179396
Provider Name (Legal Business Name): WENDY N. CORR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3404 N LECANTO HWY
BEVERLY HILLS FL
34465-3569
US

IV. Provider business mailing address

26235 JAMBOREE RD
BROOKSVILLE FL
34601-5461
US

V. Phone/Fax

Practice location:
  • Phone: 352-287-9858
  • Fax:
Mailing address:
  • Phone: 352-442-1065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: