Provider Demographics
NPI:1164700993
Name:WOLF, KARA JOY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:JOY
Last Name:WOLF
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3992
Mailing Address - Country:US
Mailing Address - Phone:210-495-9944
Mailing Address - Fax:210-495-2540
Practice Address - Street 1:225 E SONTERRA BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3992
Practice Address - Country:US
Practice Address - Phone:210-495-9944
Practice Address - Fax:210-495-2540
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106587235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist