Healthcare Provider Details

I. General information

NPI: 1144581810
Provider Name (Legal Business Name): WENDY CARANNANTE & ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WESTWOOD OFFICE PARK
FREDERICKSBURG VA
22401-5121
US

IV. Provider business mailing address

711 LAKEVIEW PKWY
LOCUST GROVE VA
22508-5131
US

V. Phone/Fax

Practice location:
  • Phone: 540-656-3114
  • Fax: 484-842-6053
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: WENDY CARANNANTE
Title or Position: LICENSED PSYCHOLOGIST
Credential: MS, EDS, NCSP
Phone: 540-656-3114