Doctor Name: | MS. JENAE LYN WOLF |
NPI Number: | 1083985790 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA,CCC,SLP |
License Number: | SP-10551 |
Business Practice Address: | 14701 Detroit Ave Lakewood, OH - 441074115 |
Business Phone Number: | 4408380990 |
Business Fax Number: | 4408388440 |
Mailing Address: | 1929 E Royalton Rd Ste A, BROADVIEW HEIGHTS |
State: | OH |
Postal Code: | 441472868 |
Phone Number: | 4408380990 |
Fax Number: | 4408388440 |
NPI Enumeration Date: | 01/26/2012 |
NPI Last Update Date: | 08/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP-10551 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |