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Individual

MS. MARCELLA B. WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1020 S MAIN ST STE 100, SALT LAKE CITY, UT 84101-3194
(888) 949-4864
Mailing address
12067 S LAMPTON VIEW DR, RIVERTON, UT 84065-7834
(575) 517-7291

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8265311-3501
UT
1041C0700X
Clinical Social Worker
I0-221
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00R32R
EXISTING BCBS PROVIDER
NJ
Enumeration date
08/01/2006
Last updated
11/12/2018
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