Provider Demographics
NPI:1619691755
Name:WOLFSON, ALICIA (LCGC)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DR.
Mailing Address - Street 2:GENETICS DEPT.
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:380-215-1246
Mailing Address - Fax:614-722-3546
Practice Address - Street 1:700 CHILDRENS DR.
Practice Address - Street 2:GENETICS DEPT.
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:380-215-1246
Practice Address - Fax:614-722-3546
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000747170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS