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General NPI Number Information
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NPI Number | 1083033534
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Entity Type | Organization
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Legal Business Name | ERIKA WOOLF PSYD LLC
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 513 CADIZ DR
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City | GROVELAND
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State | FL
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Zip | 34736-8017
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Country | US
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Telephone | 352-689-7238
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 121735
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City | CLERMONT
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State | FL
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Zip | 34712-1735
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Country | US
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Telephone | 352-689-7238
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIKA L WOOLF
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Credential | PSY.D
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Telephone | 352-689-7238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | PY8232
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License Number State | FL
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