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Individual

MS. BETTE LOIS WOLFGANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 253-1686
Mailing address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 253-1686

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
118
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790731081
KY
Enumeration date
01/03/2007
Last updated
04/11/2012
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