Provider Demographics
NPI:1932815586
Name:WOLFE-WEAVER, SHAUNDI ANN (LAMFT)
Entity Type:Individual
Prefix:
First Name:SHAUNDI
Middle Name:ANN
Last Name:WOLFE-WEAVER
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SPRUCE ST APT K
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-5024
Mailing Address - Country:US
Mailing Address - Phone:208-610-8428
Mailing Address - Fax:
Practice Address - Street 1:2023 SANDPOINT WEST DR
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-7304
Practice Address - Country:US
Practice Address - Phone:208-265-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLAMFT8701106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist