Provider Demographics
NPI:1649355611
Name:WOLFE, KRISTIN LEIGH ANN (MSW, GSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEIGH ANN
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MSW, GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 W ESPLANADE AVE S
Mailing Address - Street 2:STE 213
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-7406
Mailing Address - Country:US
Mailing Address - Phone:504-838-5716
Mailing Address - Fax:504-838-5714
Practice Address - Street 1:5001 WESTBANK EXPY
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2922
Practice Address - Country:US
Practice Address - Phone:504-349-8708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8619104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker