Healthcare Provider Details

I. General information

NPI: 1225947179
Provider Name (Legal Business Name): COLIN WOLFE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 N COUNTRY CLUB RD
TUCSON AZ
85716-1910
US

IV. Provider business mailing address

5152 E PEACH ST
TUCSON AZ
85712-3624
US

V. Phone/Fax

Practice location:
  • Phone: 520-423-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number23253
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: