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General NPI Number Information
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NPI Number | 1801371208
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Entity Type | Organization
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Legal Business Name | MARLENE M WOLF, LLC
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 1200 HIGH RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06905-1223
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Country | US
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Telephone | 203-856-9852
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Fax |
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Provider Business Mailing Address
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Address Line | 22 TRYON AVE
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City | RUMFORD
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State | RI
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Zip | 02916-1834
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Country | US
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Telephone | 203-856-9852
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MARLENE M WOLF
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Credential |
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Telephone | 203-856-9852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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