Provider Demographics
NPI:1194290593
Name:WOLF, NOELLE (MA, ATR-P)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:WOLF
Suffix:
Gender:F
Credentials:MA, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 27TH AVE S # 248
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1565
Mailing Address - Country:US
Mailing Address - Phone:612-367-7163
Mailing Address - Fax:
Practice Address - Street 1:2637 27TH AVE S STE 237
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3196
Practice Address - Country:US
Practice Address - Phone:612-367-7163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist