Provider Demographics
NPI:1962572750
Name:WOHLSIFER, DAVID B (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:WOHLSIFER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 CAMINO GARDENS BLVD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5816
Mailing Address - Country:US
Mailing Address - Phone:561-409-9701
Mailing Address - Fax:561-922-0371
Practice Address - Street 1:370 CAMINO GARDENS BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5816
Practice Address - Country:US
Practice Address - Phone:561-409-9701
Practice Address - Fax:561-922-0371
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0133091041C0700X
FLSW 116731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
EINOther20-0389297
46-4454955OtherEIN