Doctor Name: | MS. VIRGINIA MASON WOLFARTH |
NPI Number: | 1437280930 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED., LPC |
License Number: | 7886 |
Business Practice Address: | 21910 Fm 16 W Lindale, TX - 757715504 |
Business Phone Number: | 9038826649 |
Business Fax Number: | |
Mailing Address: | 21910 Fm 16 W, LINDALE |
State: | TX |
Postal Code: | 757715504 |
Phone Number: | 9038826649 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 06/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 7886 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |