Provider Demographics
NPI:1194078162
Name:WOLFE, ALAINA J (CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:ALAINA
Middle Name:J
Last Name:WOLFE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25221 MILES ROAD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128
Mailing Address - Country:US
Mailing Address - Phone:216-514-1600
Mailing Address - Fax:
Practice Address - Street 1:25221 MILES RD
Practice Address - Street 2:SUITE F
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5474
Practice Address - Country:US
Practice Address - Phone:216-514-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP10235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist