Individual
LESA WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3099 NE DIAMOND LAKE BLVD, ROSEBURG, OR 97470-3655
(541) 672-2691
(541) 673-5642
Mailing address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 672-2691
(541) 673-5642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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