Healthcare Provider Details

I. General information

NPI: 1003210261
Provider Name (Legal Business Name): MOLLY ANDERSON WOLF M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1180
CARTHAGE NC
28327-1180
US

IV. Provider business mailing address

345 CLEARFIELD LN
SOUTHERN PINES NC
28387-7100
US

V. Phone/Fax

Practice location:
  • Phone: 910-947-2976
  • Fax: 910-947-3011
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3188
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: