MEDICARE: MINDY EVE WOLFF

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	225XP0200X	Pediatric Occupational Therapist		CA

General Provider Information

NPI Number	:	1912291634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINDY EVE WOLFF

Provider Business Mailing Address
First Line	:	1001 EAST BAYAUD AVE
Second Line	:	APT.1608
City	:	DENVER
State	:	CO
Zip	:	80209
Country	:	US
Telephone Number	:	323-806-6779
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 E BAYAUD AVE
Second Line	:	APT.1608
City	:	DENVER
State	:	CO
Zip	:	80209-2303
Country	:	US
Telephone Number	:	323-806-6779
Fax Number	:

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

Provider Enumeration Date	:	05/31/2011
Last Update Date	:	05/31/2011

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