Healthcare Provider Details

I. General information

NPI: 1912039504
Provider Name (Legal Business Name): JANICE ELIZABETH WOLFENBERG CPM, L.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2007
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ROCKY SPRINGS RD
HONESDALE PA
18431-4127
US

IV. Provider business mailing address

21 ROCKY SPRINGS RD
HONESDALE PA
18431-4127
US

V. Phone/Fax

Practice location:
  • Phone: 414-313-1464
  • Fax: 414-877-1174
Mailing address:
  • Phone: 414-313-1464
  • Fax: 414-877-1174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: