Provider Demographics
NPI:1689828030
Name:WOLTER, MARGUERITE J (MA)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:J
Last Name:WOLTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MEG
Other - Middle Name:J
Other - Last Name:WOLTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:260 E CHESTNUT ST
Mailing Address - Street 2:#4201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2401
Mailing Address - Country:US
Mailing Address - Phone:415-305-6907
Mailing Address - Fax:
Practice Address - Street 1:260 E CHESTNUT ST
Practice Address - Street 2:#4201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2401
Practice Address - Country:US
Practice Address - Phone:415-305-6907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional