Healthcare Provider Details

I. General information

NPI: 1821495102
Provider Name (Legal Business Name): ALISSA WOLFE ROSELL PT, DPT, OMPT, OCS,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. ALISSA WOLFE

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 N LOOP 336 W SUITE 140 PMB 1029
CONROE TX
77304
US

IV. Provider business mailing address

2257 N LOOP 336 W SUITE 140 PMB 1029
CONROE TX
77304
US

V. Phone/Fax

Practice location:
  • Phone: 832-378-7257
  • Fax:
Mailing address:
  • Phone: 323-787-2578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberT04095
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT-4291
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: