Provider Demographics
NPI:1356932750
Name:WOLFE, STEPHANIE MARIE (QMHS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MARIE
Other - Last Name:ALRUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 JAVIT CT
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2439
Mailing Address - Country:US
Mailing Address - Phone:330-797-4050
Mailing Address - Fax:330-797-4090
Practice Address - Street 1:104 JAVIT CT
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2439
Practice Address - Country:US
Practice Address - Phone:330-797-4050
Practice Address - Fax:330-797-4090
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator