Provider Demographics
NPI:1184681835
Name:WOOLF, PAUL L (CMHC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:L
Last Name:WOOLF
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5689 S REDWOOD RD UNIT 27
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5499
Mailing Address - Country:US
Mailing Address - Phone:801-266-2485
Mailing Address - Fax:
Practice Address - Street 1:5689 S REDWOOD RD UNIT 27
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5499
Practice Address - Country:US
Practice Address - Phone:801-266-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT367516004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107032318101OtherIHC