Provider Demographics
NPI:1598295578
Name:WOLFE, HEATHER MORGAN (MS, ATC)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:MORGAN
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 COLLAMER RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-1060
Mailing Address - Country:US
Mailing Address - Phone:302-723-6801
Mailing Address - Fax:
Practice Address - Street 1:1570 BALTIMORE PIKE
Practice Address - Street 2:MANUEL RIVERO HALL
Practice Address - City:LINCOLN UNIVERSITY
Practice Address - State:PA
Practice Address - Zip Code:19352
Practice Address - Country:US
Practice Address - Phone:484-365-7615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT11862255A2300X
PARTO0001982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer