| NPI | 1891209284 |
|---|---|
| Former Legal Business Name | JESSICA J. WOLKE |
| Entity Type | Organization |
| Authorized Contact | TONYA CASSELL Billing Agent 860-405-4951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW01554) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2024-01-01 |