Individual
MR. CHARLES WALTER WOLFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
620 HOWARD AVE, ALTOONA, PA 16601-4804
(814) 889-2141
(814) 889-7999
Mailing address
804 W 15TH ST, TYRONE, PA 16686-2100
(814) 684-4022
(814) 889-7999
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW004708E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138020
GADRIAN CIGNA BEHAVIORAL
PA
01
—
17595
GEISINGER
PA
01
—
273989
MAGELLAN
PA
01
—
629812
HIGHMARK
PA
Enumeration date
01/17/2007
Last updated
07/08/2007
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