Wolf, Deanna Marie

Wolf, Deanna Marie is an individual health care provider with primary practice located at 1300 E Bradford Pkwy , Springfield MO 65804-4264. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wolf, Deanna Marie can be contacted via phone (417) 761-5000.

Contact Information

Primary practice address
1300 E Bradford Pkwy Springfield MO 65804-4264
Phone: (417) 761-5000
Fax: (417) 761-5011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2007038811 Missouri
Behavioral Health & Social Service Providers / Forensic 103TF0200X 2007038811 Missouri
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2007038811 Missouri

Profile Details

NPI number 1669798310
LBN Legal business name Wolf, Deanna Marie
Credentials PSYD, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2010
Last updated Mar 25th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669798310 NPPES
Missouri MEDICAID 494204001

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