Provider Demographics
NPI:1912566431
Name:WOLFF, CASSANDRA JANE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JANE
Last Name:WOLFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8327 LORRIE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2714
Mailing Address - Country:US
Mailing Address - Phone:216-633-6979
Mailing Address - Fax:
Practice Address - Street 1:639 SWEDESFORD RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1530
Practice Address - Country:US
Practice Address - Phone:610-616-5935
Practice Address - Fax:484-318-7166
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional