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NPI Code Detail

MEDICARE: MRS. KARON ANNETTE WOLFE LISW

MEDICARE: MRS. KARON ANNETTE WOLFE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS 0027588OH
21041C0700XClinical Social WorkerI. 0800012OH

General Provider Information

NPI Number : 1235282955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KARON ANNETTE WOLFE LISW
Provider Business Mailing Address
First Line : 127 W HARMON DR
Second Line :
City : GREENVILLE
State : OH
Zip : 45331-2335
Country : US
Telephone Number : 937-547-9118
Fax Number :
Provider Business Practice Location Address
First Line : 212 E MAIN ST
Second Line :
City : GREENVILLE
State : OH
Zip : 45331-1913
Country : US
Telephone Number : 937-548-1635
Fax Number : 937-548-1500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 03/10/2008

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