Provider Demographics
NPI:1679730659
Name:WOLFE, JOANNE (MA)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:928 FALLS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6213
Mailing Address - Country:US
Mailing Address - Phone:802-598-9967
Mailing Address - Fax:
Practice Address - Street 1:928 FALLS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482-6213
Practice Address - Country:US
Practice Address - Phone:802-598-9967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT047-0000729103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist