Basic Information
| Provider Information | |||||||||
| NPI: | 1881639524 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEWOLFE | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | JOAN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4811 S BUTLER RD | ||||||||
| Address2: | |||||||||
| City: | MORRISVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134082440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3156843995 | ||||||||
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| Practice Location | |||||||||
| Address1: | 201 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | ONEIDA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134212111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153618413 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 220351-1 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.