Healthcare Provider Details

I. General information

NPI: 1972524890
Provider Name (Legal Business Name): BARBARA ANNE DEWOLFE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13215 SPRING HILL DR
SPRING HILL FL
34609-5054
US

IV. Provider business mailing address

4385 GEVALIA DR
BROOKSVILLE FL
34604-5806
US

V. Phone/Fax

Practice location:
  • Phone: 352-683-1842
  • Fax:
Mailing address:
  • Phone: 352-277-3245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5294
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: