Provider Demographics
NPI:1275024069
Name:WOLTER, ULRIKE BARBARA (PHD)
Entity Type:Individual
Prefix:
First Name:ULRIKE
Middle Name:BARBARA
Last Name:WOLTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 E CUMBERLAND AVE UNIT 2801
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4262
Mailing Address - Country:US
Mailing Address - Phone:813-225-2057
Mailing Address - Fax:
Practice Address - Street 1:1209 E CUMBERLAND AVE UNIT 2801
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4262
Practice Address - Country:US
Practice Address - Phone:813-225-2057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6605-PY-PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist