Provider Demographics
NPI:1679344238
Name:WOLZ, KENDALL MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:MARIE
Last Name:WOLZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1329
Mailing Address - Street 2:ATTN: KENDALL WOLZ
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096
Mailing Address - Country:US
Mailing Address - Phone:770-497-9122
Mailing Address - Fax:
Practice Address - Street 1:3505 DULUTH PARK LN STE 200
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3203
Practice Address - Country:US
Practice Address - Phone:770-497-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7657101YP2500X
GA013914101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional