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NPI Code Detail

MEDICARE: JENDEL WOLFE PLPC

MEDICARE:   JENDEL  WOLFE  PLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2022045285MO

General Provider Information

NPI Number : 1164292330
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENDEL WOLFE PLPC
Provider Business Mailing Address
First Line : 15424 LAWRENCE 1110
Second Line :
City : MOUNT VERNON
State : MO
Zip : 65712-9311
Country : US
Telephone Number : 417-669-6692
Fax Number :
Provider Business Practice Location Address
First Line : 15424 LAWRENCE 1110
Second Line :
City : MOUNT VERNON
State : MO
Zip : 65712-9311
Country : US
Telephone Number : 176-696-6924
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2024
Last Update Date : 01/08/2024

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Directions to “ JENDEL WOLFE PLPC” Practice Location

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