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General NPI Number Information
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NPI Number | 1326252172
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Entity Type | Organization
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Legal Business Name | AMOS N. WOLF
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 300 N MAIN ST
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City | TAYLOR
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State | TX
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Zip | 76574-3641
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Country | US
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Telephone | 512-365-2211
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Fax | 512-352-6691
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Provider Business Mailing Address
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Address Line | PO BOX 1226
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City | TAYLOR
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State | TX
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Zip | 76574-6226
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Country | US
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Telephone | 512-635-2211
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Fax | 512-352-6691
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Authorized Official
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Title or Position | OWNER
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Name | AMOS WOLF
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Credential | PH.D.
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Telephone | 512-365-2211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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