| Doctor Name: | MR. BRIAN WIRT WOOLLEY |
| NPI Number: | 1235359365 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 68615 Perez Rd Cathedral City, CA - 922347200 |
| Business Phone Number: | 7607702222 |
| Business Fax Number: | |
| Mailing Address: | 9989 Vista Del Valle, DESERT HOT SPRINGS |
| State: | CA |
| Postal Code: | 922401750 |
| Phone Number: | 7607702222 |
| Fax Number: | |
| NPI Enumeration Date: | 04/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |