Provider Demographics
NPI:1578275392
Name:WOLFE, WENDY LEECH
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:LEECH
Last Name:WOLFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19660 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:GAMBIER
Mailing Address - State:OH
Mailing Address - Zip Code:43022-9712
Mailing Address - Country:US
Mailing Address - Phone:740-507-2922
Mailing Address - Fax:
Practice Address - Street 1:19660 BAKER RD
Practice Address - Street 2:
Practice Address - City:GAMBIER
Practice Address - State:OH
Practice Address - Zip Code:43022-9712
Practice Address - Country:US
Practice Address - Phone:740-507-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker