Provider Demographics
NPI:1003065483
Name:WOLFE-CHRISTENSEN, CORTNEY B (PHD)
Entity Type:Individual
Prefix:DR
First Name:CORTNEY
Middle Name:B
Last Name:WOLFE-CHRISTENSEN
Suffix:
Gender:F
Credentials:PHD
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 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:750 8TH AVE FL 6
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2515
Practice Address - Country:US
Practice Address - Phone:682-303-0376
Practice Address - Fax:682-303-0377
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014400103TC2200X
TX37538103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent