Doctor Name: | JUDITH L. WOLFE |
NPI Number: | 1053494690 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 004741 |
Business Practice Address: | 211 Pleasant Home Rd Suite B-2 Martinez, GA - 309070518 |
Business Phone Number: | 7065131313 |
Business Fax Number: | 7068540432 |
Mailing Address: | 1318 Wingfield St, AUGUSTA |
State: | GA |
Postal Code: | 309044757 |
Phone Number: | 7065131313 |
Fax Number: | 7067331098 |
NPI Enumeration Date: | 10/24/2006 |
NPI Last Update Date: | 07/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 004741 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |