Healthcare Provider Details

I. General information

NPI: 1275794406
Provider Name (Legal Business Name): WOLFE NEUROPSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6012 W WILLIAM CANNON DR B-103
AUSTIN TX
78749-1980
US

IV. Provider business mailing address

2303 RR 620 S SUITE 135 OFFICE 137
LAKEWAY TX
78734-6219
US

V. Phone/Fax

Practice location:
  • Phone: 512-203-9957
  • Fax:
Mailing address:
  • Phone: 512-203-9957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MONICA E. WOLFE
Title or Position: DIRECTOR
Credential: PH.D., L.P.
Phone: 512-203-9957