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General NPI Number Information
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NPI Number | 1306194725
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Entity Type | Individual
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Provider Name | WENONA ALLEN
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 1724 ML KING BLVD
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City | MIDWAY
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State | FL
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Zip | 32343
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Country | US
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Telephone | 850-404-2650
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Fax | 850-809-9609
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Provider Business Mailing Address
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Address Line | 1724 MLK BLVD 1724 MLK
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City | MIDWAY
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State | FL
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Zip | 32343
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Country | US
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Telephone | 850-294-4254
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | FL
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