Provider Demographics
NPI:1912291634
Name:WOLFF, MINDY EVE
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:EVE
Last Name:WOLFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 EAST BAYAUD AVE
Mailing Address - Street 2:APT.1608
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:323-806-6779
Mailing Address - Fax:
Practice Address - Street 1:1001 E BAYAUD AVE
Practice Address - Street 2:APT.1608
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2303
Practice Address - Country:US
Practice Address - Phone:323-806-6779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics