| Doctor Name: | MRS. MALORIE NICHOLE WENZEL |
| NPI Number: | 1376998211 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LSW |
| License Number: | S.1100254 |
| Business Practice Address: | 6 Public Sq Galion, OH - 448331926 |
| Business Phone Number: | 5675603583 |
| Business Fax Number: | 4197777912 |
| Mailing Address: | 151 Marion Ave, MANSFIELD |
| State: | OH |
| Postal Code: | 449032223 |
| Phone Number: | 4197749969 |
| Fax Number: | 4197565642 |
| NPI Enumeration Date: | 04/28/2016 |
| NPI Last Update Date: | 04/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | S.1100254 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |