| NPI | 1538694211 | 
|---|---|
| Former Name | ANDREA WOLFE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006382) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2017-05-01 | 
| Last Update Date | 2023-09-22 |