Chisholm, Wanda
Chisholm, Wanda is an individual health care provider with primary practice located at 1304 E Osborne Ave , Tampa FL 33603. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Chisholm, Wanda can be contacted via phone (813) 231-3146.Contact Information
Primary practice address
1304 E Osborne Ave
Tampa FL 33603
Phone: (813) 231-3146
Fax: (813) 231-3146
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1568636561 |
|---|---|
| LBN Legal business name | Chisholm, Wanda |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 22nd, 2008 |
| Last updated | Apr 22nd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568636561 | NPPES |
| Florida | MEDICAID | 691790998 | |
| Florida | MEDICAID | 691790996 |
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