Healthcare Provider Details

I. General information

NPI: 1306232103
Provider Name (Legal Business Name): WENDY MOSHOLDER-HART LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 T G LEE BLVD STE 205
ORLANDO FL
32822-4408
US

IV. Provider business mailing address

5850 T G LEE BLVD STE 205
ORLANDO FL
32822-4408
US

V. Phone/Fax

Practice location:
  • Phone: 407-519-0015
  • Fax:
Mailing address:
  • Phone: 407-519-0015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH7409
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: