Provider Demographics
NPI:1447407903
Name:WOLF MEHLMAN PSYCHOLOGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:WOLF MEHLMAN PSYCHOLOGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF MEHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-744-4494
Mailing Address - Street 1:31 S FULLERTON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3358
Mailing Address - Country:US
Mailing Address - Phone:973-744-4494
Mailing Address - Fax:973-744-4492
Practice Address - Street 1:31 S FULLERTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3358
Practice Address - Country:US
Practice Address - Phone:973-744-4494
Practice Address - Fax:973-744-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4546103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty