Provider Demographics
NPI:1588537898
Name:WOLFORD, REBECCA L
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:WOLFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANAMOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52205-5701
Mailing Address - Country:US
Mailing Address - Phone:319-224-0722
Mailing Address - Fax:877-728-2951
Practice Address - Street 1:213 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANAMOSA
Practice Address - State:IA
Practice Address - Zip Code:52205-5701
Practice Address - Country:US
Practice Address - Phone:319-224-0722
Practice Address - Fax:877-728-2951
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA133967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health