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Individual

DR. DEANNA M WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD, LP

Contact information

Practice address
1300 E BRADFORD PKWY BLDG B, SPRINGFIELD, MO 65804-4264
(417) 761-5000
Mailing address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952
(417) 761-5000

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
2007038811
MO
103TC0700X
Clinical Psychologist
Primary
2007038811
MO
103TF0200X
Forensic Psychologist
2007038811
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
494204001
MO
Enumeration date
04/19/2010
Last updated
03/31/2026
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