Provider Demographics
NPI:1497894331
Name:WOLF, ANNE KRISTINE (LCMHC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:KRISTINE
Last Name:WOLF
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:
Other - Last Name:WOLF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMHC
Mailing Address - Street 1:37 QUARRY CIR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4146
Mailing Address - Country:US
Mailing Address - Phone:603-213-6177
Mailing Address - Fax:
Practice Address - Street 1:120 BEDFORD CENTER RD STE 302
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5442
Practice Address - Country:US
Practice Address - Phone:603-488-1773
Practice Address - Fax:603-488-1773
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME557101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional