| Doctor Name: | MR. STEVEN FAST WOLF |
| NPI Number: | 1053516856 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPCC |
| License Number: | 0096041 |
| Business Practice Address: | 3029 Queen Street Crownpoint, NM - 873131893 |
| Business Phone Number: | 5057864207 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1893, CROWNPOINT |
| State: | NM |
| Postal Code: | 873131893 |
| Phone Number: | 5057864207 |
| Fax Number: | |
| NPI Enumeration Date: | 06/20/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0096041 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |