MEDICARE: TOVAH WOLF PHD, MS, RDN, LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LD.09681	OH
2	133V00000X	Registered Dietitian	087243	IA

General Provider Information

NPI Number	:	1427722214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOVAH WOLF PHD, MS, RDN, LDN

Provider Business Mailing Address
First Line	:	4505 KENNY RD # 1019
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-4034
Country	:	US
Telephone Number	:	701-789-0553
Fax Number	:

Provider Business Practice Location Address
First Line	:	4505 KENNY RD # 1019
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-4034
Country	:	US
Telephone Number	:	701-789-0553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2021
Last Update Date	:	11/26/2024

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