Provider Demographics
NPI:1689852121
Name:WOLERY, MARY CHRISTINE (EDS, MFT,LADC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CHRISTINE
Last Name:WOLERY
Suffix:
Gender:F
Credentials:EDS, MFT,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SHERIDAN LN
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-6546
Mailing Address - Country:US
Mailing Address - Phone:775-720-8445
Mailing Address - Fax:775-782-2231
Practice Address - Street 1:1677 LUCERNE ST STE B
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4347
Practice Address - Country:US
Practice Address - Phone:775-720-8445
Practice Address - Fax:775-782-2231
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV538101YA0400X
NV01146106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)