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Individual

DR. LISA H. WOLFE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
173 MOUNT AUBURN ST, WATERTOWN, MA 02472-4005
(617) 924-0303
Mailing address
173 MOUNT AUBURN ST, WATERTOWN, MA 02472-4005
(617) 924-0303

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6250
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0521736
MA
01
1171331
CCN FIRST HEALTH
MA
01
766312
TUFTS HEALTH PLAN
MA
Enumeration date
01/11/2007
Last updated
12/20/2010
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