MEDICARE: DR. JODI BREMER WOLF PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	PS018125	PA

General Provider Information

NPI Number	:	1326596834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JODI BREMER WOLF PH.D.

Provider Business Mailing Address
First Line	:	1055 WESTLAKES DR STE 300
Second Line	:
City	:	BERWYN
State	:	PA
Zip	:	19312-2410
Country	:	US
Telephone Number	:	267-772-8768
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 WESTLAKES DR STE 300
Second Line	:
City	:	BERWYN
State	:	PA
Zip	:	19312-2410
Country	:	US
Telephone Number	:	267-772-8768
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	01/05/2026

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