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Individual

KELLY WOLFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
729 MULBERRY AVE, BREA, CA 92821-6456
(805) 720-6859
Mailing address
PO BOX 921, BREA, CA 92822-0921
(805) 720-6859

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
15983
CA

Other

Enumeration date
02/03/2016
Last updated
02/03/2016
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