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NPI Code Detail

MEDICARE: NICOLE ANN WOLFF CONLEY MSW

MEDICARE: NICOLE ANN WOLFF CONLEY MSW
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 Worker

General Provider Information

NPI Number : 1265789218
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE ANN WOLFF CONLEY MSW
Provider Business Mailing Address
First Line : 4329 OLIVE AVE
Second Line :
City : LA MESA
State : CA
Zip : 91941-6110
Country : US
Telephone Number : 619-405-1641
Fax Number :
Provider Business Practice Location Address
First Line : 2555 E GILA RIDGE RD
Second Line :
City : YUMA
State : AZ
Zip : 85365-2240
Country : US
Telephone Number : 928-317-9973
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2012
Last Update Date : 08/09/2012

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Directions to “ NICOLE ANN WOLFF CONLEY MSW” Practice Location

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