Provider Demographics
NPI:1780625798
Name:WOLF, BARBARA B (MA CCCA)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:B
Last Name:WOLF
Suffix:
Gender:F
Credentials:MA CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 COLLINS ROAD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468
Mailing Address - Country:US
Mailing Address - Phone:617-965-4333
Mailing Address - Fax:
Practice Address - Street 1:2000 WASHINGTON STREET
Practice Address - Street 2:ELY A KIRSCHNER MD PC SUITE 320
Practice Address - City:NEWTON LOWER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-965-6030
Practice Address - Fax:617-965-6525
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAD0051OtherBCBS
MAW0032464Medicare ID - Type Unspecified