Provider Demographics
NPI:1003015520
Name:WOLFE, OLAIDE TEMITOPE (BSW)
Entity Type:Individual
Prefix:MRS
First Name:OLAIDE
Middle Name:TEMITOPE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221876
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-1876
Mailing Address - Country:US
Mailing Address - Phone:907-929-2828
Mailing Address - Fax:907-929-5858
Practice Address - Street 1:405 E FIREWEED LN STE 202
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2145
Practice Address - Country:US
Practice Address - Phone:907-929-2828
Practice Address - Fax:907-929-5858
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK737091171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator