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General NPI Number Information
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NPI Number | 1053494690
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Entity Type | Individual
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Provider Name | JUDITH L. WOLFE LPC
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 211 PLEASANT HOME RD SUITE B-2
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City | MARTINEZ
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State | GA
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Zip | 30907-0518
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Country | US
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Telephone | 706-513-1313
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Fax | 706-854-0432
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Provider Business Mailing Address
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Address Line | 1318 WINGFIELD ST
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City | AUGUSTA
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State | GA
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Zip | 30904-4757
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Country | US
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Telephone | 706-513-1313
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Fax | 706-733-1098
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 004741
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License Number State | GA
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