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General NPI Number Information
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NPI Number | 1093533887
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Entity Type | Organization
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Legal Business Name | CANDICE WOLFF BEHAVIORAL CONSULTANT
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 6510 MARSH CT
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-8422
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Country | US
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Telephone | 850-307-8811
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Fax |
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Provider Business Mailing Address
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Address Line | 6510 MARSH CT
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-8422
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/BCBA
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Name | CANDICE WOLFF
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Credential |
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Telephone | 850-307-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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