Provider Demographics
NPI:1013123546
Name:WOLF, CARMELA ARA
Entity Type:Individual
Prefix:MRS
First Name:CARMELA
Middle Name:ARA
Last Name:WOLF
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ALMA
Other - Middle Name:CATHERINE
Other - Last Name:FERRERA-GRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3055 PUALEI CIR
Mailing Address - Street 2:APT.106
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4910
Mailing Address - Country:US
Mailing Address - Phone:808-228-4732
Mailing Address - Fax:
Practice Address - Street 1:3055 PUALEI CIR
Practice Address - Street 2:APT.106
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-4910
Practice Address - Country:US
Practice Address - Phone:808-228-4732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI821171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist