Provider Demographics
NPI:1083922942
Name:WOLF, ANN M (LPC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:WOLF
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 1:71 IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1645
Mailing Address - Country:US
Mailing Address - Phone:732-245-4208
Mailing Address - Fax:
Practice Address - Street 1:71 IROQUOIS AVE
Practice Address - Street 2:
Practice Address - City:OCEANPORT
Practice Address - State:NJ
Practice Address - Zip Code:07757-1645
Practice Address - Country:US
Practice Address - Phone:732-245-4208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00396000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional