1891757647 NPI number — MRS. BARBARA N WOLFE LPC

Table of content: MRS. BARBARA N WOLFE LPC (NPI 1891757647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891757647 NPI number — MRS. BARBARA N WOLFE LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOLFE
Provider First Name:
BARBARA
Provider Middle Name:
N
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891757647
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
521 EVERGREEN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36608-3845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-345-7714
Provider Business Mailing Address Fax Number:
251-342-5880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4367 DOWNTOWNER LOOP N
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36609-5539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-316-3690
Provider Business Practice Location Address Fax Number:
251-316-3691
Provider Enumeration Date:
04/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  1734 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1734 . This is a "LPC" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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