Provider Demographics
NPI:1447422654
Name:WOLFE, MARSHA ANN (TLMFT)
Entity Type:Individual
Prefix:MISS
First Name:MARSHA
Middle Name:ANN
Last Name:WOLFE
Suffix:
Gender:F
Credentials:TLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 S LARK LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3401
Mailing Address - Country:US
Mailing Address - Phone:316-993-0274
Mailing Address - Fax:
Practice Address - Street 1:24401 W MACARTHUR RD
Practice Address - Street 2:
Practice Address - City:GODDARD
Practice Address - State:KS
Practice Address - Zip Code:67052-8713
Practice Address - Country:US
Practice Address - Phone:316-794-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTLMFT 868106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist