Provider Demographics
NPI:1467585125
Name:WOLF, CHRISTINA (LIC AC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:WOLF
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DEPOT ST
Mailing Address - Street 2:SUITE 20-230
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1453
Mailing Address - Country:US
Mailing Address - Phone:603-924-5227
Mailing Address - Fax:603-924-5724
Practice Address - Street 1:20 DEPOT ST
Practice Address - Street 2:SUITE 20-230
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1453
Practice Address - Country:US
Practice Address - Phone:603-924-5227
Practice Address - Fax:603-924-5724
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHACP009171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist