Provider Demographics
NPI:1881664563
Name:WEBB, WANDA RAE (LCSW, CAP, PHD)
Entity Type:Individual
Prefix:DR
First Name:WANDA
Middle Name:RAE
Last Name:WEBB
Suffix:
Gender:F
Credentials:LCSW, CAP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U.S. NAVAL HOSPITAL, SIGONELLA
Mailing Address - Street 2:PSC 836 BOX 14
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09636
Mailing Address - Country:IT
Mailing Address - Phone:0113909-556-4840
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL, SIGONELLA
Practice Address - Street 2:PSC 836 BOX 2670
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09636
Practice Address - Country:IT
Practice Address - Phone:0113909-556-4250
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW28161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical