Individual
MRS. SUSAN TIPTON WOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
19 LAURELWOOD CV, JACKSON, TN 38305-8559
(731) 660-8516
(731) 660-8516
Mailing address
19 LAURELWOOD CV, JACKSON, TN 38305-8559
(731) 660-8516
(731) 660-8516
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0000000367
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091027
VALUEOPTIONS
TN
01
—
2008640
BLUECROSS BLUESHIELD TN
TN
Enumeration date
03/25/2007
Last updated
05/19/2010
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