Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PE1297 | TN |
N | 103T00000X | Psychologist | PE1297 | TN |
N | 103TH0100X | Health Service | PE1297 | TN |
NPI | 1619036159 |
---|---|
Provider Name | Ms. Robin Dewanna Wolfe |
First Address | Kingsport, TN 37660 |
Second Address | Kingsport, TN 37660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |