Provider Demographics
NPI:1023897105
Name:WOLFF-HERDA, OLIVIA MCKAY (MA)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MCKAY
Last Name:WOLFF-HERDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-1521
Mailing Address - Country:US
Mailing Address - Phone:763-250-7357
Mailing Address - Fax:855-221-4223
Practice Address - Street 1:116 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-1521
Practice Address - Country:US
Practice Address - Phone:763-250-7357
Practice Address - Fax:855-221-4223
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor