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General NPI Number Information
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NPI Number | 1447263876
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Entity Type | Individual
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Provider Name | TERI LYN WOLF M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 101 W LIBERTY ST APT 360
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City | ANN ARBOR
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State | MI
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Zip | 48104-1365
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Country | US
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Telephone | 734-997-9484
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Fax | 734-997-9484
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Provider Business Mailing Address
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Address Line | 101 W. LIBERTY ST., SUITE 360
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City | ANN ARBOR
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State | MI
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Zip | 48104-9520
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Country | US
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Telephone | 734-997-9484
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Fax | 734-997-9484
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4301074082
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301074082
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License Number State | MI
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