Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | FL |
NPI | 1013105493 |
---|---|
Provider Name | Ms. Cary Schwencke |
First Address | Pensacola, FL 32501-4422 |
Second Address | Pensacola, FL 32501-4422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 10/10/2007 |