Organization
BRENDA L WOLFE PHD PC
Active
Organization
BRENDA L WOLFE PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA L WOLFE PHD (PRESIDENT/CEO)
(505) 884-5700
Entity
Organization
Contact information
Practice address
2200 GRANDE SE BLVD, STE B, RIO RANCHO, NM 87124-1655
(505) 884-5700
(505) 884-5701
Mailing address
2200 GRANDE SE BLVD, STE B, RIO RANCHO, NM 87124-1655
(505) 884-5700
(505) 884-5701
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0790
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM00JA81
BLUE CROSS/BLUE SHIELD
NM
05
—
NM100864
—
NM
Enumeration date
10/31/2007
Last updated
10/21/2008
Update your record
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