Provider Demographics
NPI:1861940397
Name:WENTE-BRANCH, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WENTE-BRANCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 VERBENA CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-1649
Mailing Address - Country:US
Mailing Address - Phone:321-243-7944
Mailing Address - Fax:
Practice Address - Street 1:200 E ROBINSON ST STE 425
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-4347
Practice Address - Country:US
Practice Address - Phone:321-243-7944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2023-01-08
Deactivation Date:2018-09-26
Deactivation Code:
Reactivation Date:2021-01-13
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 104100000X, 171M00000X
FLSW204361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator