Provider Demographics
NPI:1881642718
Name:WOLFE, HONORA LEE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:HONORA
Middle Name:LEE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:S
Other - Last Name:FLAWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:2539 COLUMBINE CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9143
Mailing Address - Country:US
Mailing Address - Phone:303-447-8372
Mailing Address - Fax:303-245-8362
Practice Address - Street 1:5441 WESTERN AVE
Practice Address - Street 2:#2
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2754
Practice Address - Country:US
Practice Address - Phone:303-447-8372
Practice Address - Fax:303-245-8362
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO134171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist