Provider Demographics
NPI:1427281765
Name:WOLFE, ANGELA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1294 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1822
Mailing Address - Country:US
Mailing Address - Phone:570-970-0229
Mailing Address - Fax:
Practice Address - Street 1:1294 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18705-1822
Practice Address - Country:US
Practice Address - Phone:570-970-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009305235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist