Provider Demographics
NPI:1295445427
Name:WOOLFOLK, XALEY ELYSE
Entity type:Individual
Prefix:
First Name:XALEY
Middle Name:ELYSE
Last Name:WOOLFOLK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W MOCKINGBIRD LN UNIT 1030
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-5028
Mailing Address - Country:US
Mailing Address - Phone:972-489-5552
Mailing Address - Fax:
Practice Address - Street 1:212 E. VANCE ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TX
Practice Address - Zip Code:75563
Practice Address - Country:US
Practice Address - Phone:903-650-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator