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Individual

KELLY R WOLFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4595 TOWNE LAKE PKWY STE 250, WOODSTOCK, GA 30189-5514
(717) 478-8486
Mailing address
104 OLDE HERITAGE WAY, WOODSTOCK, GA 30188-6121
(717) 669-0484

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC006542
GA

Other

Enumeration date
01/30/2020
Last updated
01/30/2020
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