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General NPI Number Information
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NPI Number | 1396966834
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Entity Type | Individual
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Provider Name | WENDIE GAYLE ENT LMHC, CAP, NCGC-II
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 1730 S PINELLAS AVE SUITE G
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-1959
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Country | US
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Telephone | 727-492-8037
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Fax |
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Provider Business Mailing Address
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Address Line | 602 SPARROW AVE
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City | PALM HARBOR
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State | FL
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Zip | 34683-1917
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Country | US
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Telephone | 727-492-8037
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH8019
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License Number State | FL
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