Provider Demographics
NPI:1356087639
Name:WOLFF, ANNA (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:WOLFF
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22634 SW COWLITZ DR
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8363
Mailing Address - Country:US
Mailing Address - Phone:208-340-1340
Mailing Address - Fax:
Practice Address - Street 1:22634 SW COWLITZ DR
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8363
Practice Address - Country:US
Practice Address - Phone:208-340-1340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72164103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool