Individual
LAURA WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
175 RIDGECREST DR, FAYETTEVILLE, GA 30215-4966
(770) 756-9497
Mailing address
175 RIDGECREST DR, FAYETTEVILLE, GA 30215-4966
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004325
GA
Other
Enumeration date
11/20/2006
Last updated
02/06/2008
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