Provider Demographics
NPI:1467297770
Name:WULF, ASHLEY (LPC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WULF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:JOAQUIN
Mailing Address - State:TX
Mailing Address - Zip Code:75954-0476
Mailing Address - Country:US
Mailing Address - Phone:936-657-0090
Mailing Address - Fax:
Practice Address - Street 1:9626 STATE HIGHWAY 7 E
Practice Address - Street 2:
Practice Address - City:JOAQUIN
Practice Address - State:TX
Practice Address - Zip Code:75954-3986
Practice Address - Country:US
Practice Address - Phone:936-657-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional