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General NPI Number Information
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NPI Number | 1952600538
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Entity Type | Organization
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Legal Business Name | S/S WOLFE COUNSELING, LLC
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 5120 TELECOM DR
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City | MILAN
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State | TN
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Zip | 38358-3495
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Country | US
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Telephone | 731-686-9383
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Fax | 731-686-9384
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Provider Business Mailing Address
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Address Line | 5120 TELECOM DR
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City | MILAN
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State | TN
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Zip | 38358-3495
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Country | US
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Telephone | 731-686-9383
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Fax | 731-686-9384
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. SHARON PROUT WOLFE
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Credential | BS
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Telephone | 731-686-9383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW0000001189
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License Number State | TN
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