Individual
MS. TERRI R FORD-WOLFGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
110 N 16TH ST STE 16, NORFOLK, NE 68701-3671
(402) 644-7314
(402) 644-7315
Mailing address
110 N 16TH ST STE 16, NORFOLK, NE 68701-3671
(402) 644-7314
(402) 644-7315
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3624
NE
1041C0700X
Clinical Social Worker
1341
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025531200
—
NE
Enumeration date
06/15/2007
Last updated
01/06/2011
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