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Individual

ALEXIS MARIE WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11810 TEDFORD ST, AUSTIN, TX 78753-2130
(512) 733-9704
Mailing address
11810 TEDFORD ST, AUSTIN, TX 78753-2130
(512) 733-9704

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MC60977139
WA
101YP2500X
Professional Counselor
Primary
85462
TX
101YP2500X
Professional Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
88-1484457
TX
Enumeration date
06/09/2017
Last updated
11/21/2022
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