Provider Demographics
NPI:1770761942
Name:WOOLF, DAHNA MOLDT (BASW)
Entity type:Individual
Prefix:MRS
First Name:DAHNA
Middle Name:MOLDT
Last Name:WOOLF
Suffix:
Gender:F
Credentials:BASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 ANTOINETTE WAY
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-7412
Mailing Address - Country:US
Mailing Address - Phone:859-647-6213
Mailing Address - Fax:859-384-2954
Practice Address - Street 1:2234 ANTOINETTE WAY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-7412
Practice Address - Country:US
Practice Address - Phone:859-647-6213
Practice Address - Fax:859-384-2954
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-09
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
KY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator