Individual
LIZBETH ERNA WOLFGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD PSYCHOLOGIST
Contact information
Practice address
24 SALT POND ROAD, SUITE D4, WAKEFIELD, RI 02879
(401) 789-3694
(401) 789-3748
Mailing address
555 TILLINGHAST ROAD, EAST GREENWICH, RI 02818
(401) 885-5891
(401) 789-3748
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
814
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306681
BLUE CROSS
RI
01
—
410947
BLUE CHIP
RI
05
—
LW49844
—
RI
Enumeration date
07/28/2006
Last updated
07/08/2007
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