Individual
KIM PHAN WOLFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, COBA
Contact information
Practice address
3505 EMBASSY PKWY, FAIRLAWN, OH 44333-8405
(330) 271-6107
(330) 706-4705
Mailing address
3505 EMBASSY PKWY STE 100, FAIRLAWN, OH 44333-8403
(302) 716-1073
(330) 706-4705
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
COBA.91
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-09-6600
BCBA CERTIFICATE
—
Enumeration date
12/07/2009
Last updated
03/18/2022
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