Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 2025500 | MA |
NPI | 1003099698 |
---|---|
Provider Name | Dorothea Anne Wolf |
First Address | Lowell, MA 01852-4931 |
Second Address | Lowell, MA 01852-4931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2007 |
Last Update Date | 06/12/2007 |