Individual
GRACE WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CRC, QP, LPCA
Contact information
Practice address
215 MEMORIAL DR, JACKSONVILLE, NC 28546-6333
(910) 378-4809
Mailing address
121 S QUEEN ST, KINSTON, NC 28501-4933
(910) 298-7167
(252) 686-0021
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A12562
NC
Other
Enumeration date
04/04/2018
Last updated
04/23/2021
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