Healthcare Provider Details

I. General information

NPI: 1538308010
Provider Name (Legal Business Name): DORIS FAYE WOLFE-KLINGLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 02/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 N ROSEBRIER DR
GUTHRIE OK
73044-2015
US

IV. Provider business mailing address

1020 N ROSEBRIER DR
GUTHRIE OK
73044-2015
US

V. Phone/Fax

Practice location:
  • Phone: 405-282-3127
  • Fax:
Mailing address:
  • Phone: 405-282-3127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number139
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1757
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: