Provider Demographics
NPI:1841569746
Name:WOLF, LACEY ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LACEY
Middle Name:ANN
Last Name:WOLF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:LACEY
Other - Middle Name:ANN
Other - Last Name:TIEFENTHALER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3314 CANTERBURY CT
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-3900
Mailing Address - Country:US
Mailing Address - Phone:515-310-1834
Mailing Address - Fax:515-513-3155
Practice Address - Street 1:3314 CANTERBURY CT
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-3900
Practice Address - Country:US
Practice Address - Phone:515-310-1834
Practice Address - Fax:515-513-3155
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002119235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist