Provider Demographics
NPI:1497373542
Name:WOLFF, JANELLE KIRSTEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:KIRSTEN
Last Name:WOLFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:KIRSTEN
Other - Last Name:LAWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1509 GOAT TRAIL LOOP RD
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-2257
Mailing Address - Country:US
Mailing Address - Phone:425-404-1504
Mailing Address - Fax:
Practice Address - Street 1:1509 GOAT TRAIL LOOP RD
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-2257
Practice Address - Country:US
Practice Address - Phone:425-404-1504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
WALL00002970235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist