Doctor Name: | MRS. DIANE GAIL WOLFE |
NPI Number: | 1952658098 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 146003093 |
Business Practice Address: | 1095 University Dr Edwardsville, IL - 620253961 |
Business Phone Number: | 6186561081 |
Business Fax Number: | 6186567083 |
Mailing Address: | 3801 Old Bruceville Rd, VINCENNES |
State: | IN |
Postal Code: | 475913889 |
Phone Number: | 8128864677 |
Fax Number: | 8128864678 |
NPI Enumeration Date: | 08/08/2012 |
NPI Last Update Date: | 08/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146003093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |