Provider Demographics
NPI:1245255330
Name:WOHLFORT, ROBERT WALTER (THD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WALTER
Last Name:WOHLFORT
Suffix:
Gender:M
Credentials:THD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1625 K ST NW
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1604
Mailing Address - Country:US
Mailing Address - Phone:202-628-9177
Mailing Address - Fax:804-725-2038
Practice Address - Street 1:1625 K ST NW
Practice Address - Street 2:SUITE 310
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1604
Practice Address - Country:US
Practice Address - Phone:202-628-9177
Practice Address - Fax:804-725-2038
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY 653103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPSY 653OtherCLINICAL PSYCHOLOGIST
DCPSY 653OtherCLINICAL PSYCHOLOGIST