Provider Demographics
NPI:1710344619
Name:WOLFF, CAITLYNN
Entity Type:Individual
Prefix:
First Name:CAITLYNN
Middle Name:
Last Name:WOLFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAITLYNN
Other - Middle Name:
Other - Last Name:LULL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1800 COOPER POINT RD SW
Mailing Address - Street 2:BLDG 21
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1178
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 COOPER POINT RD SW
Practice Address - Street 2:BLDG 21
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1178
Practice Address - Country:US
Practice Address - Phone:360-810-1547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst