Provider Information for 1225240039
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Miss MICHELLE J. WOLL LPC
Other Names:Former Name:Mrs. MICHELLE J WOLL-MADDOX LPCSex: Female
NPI: 1225240039
Last Updated: 2024-01-19
Certification Date: 2022-08-23
Certification Date: 2022-08-23
Details
| Name | Value | ||||||||
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| NPI | 1225240039 | ||||||||
| Enumeration Date | 2007-05-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4709 ELK CREEK DR YUKON, OK 73099-2300 United States Phone: 405-826-6731 | Fax: | ||||||||
| Primary Practice Address | 4709 ELK CREEK DR YUKON, OK 73099-2300 United States Phone: 405-826-6731 | Fax: | ||||||||
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