Provider Demographics
NPI:1174707814
Name:WOLF-DORLESTER, BARBARA (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:WOLF-DORLESTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 W 96TH ST
Mailing Address - Street 2:1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6403
Mailing Address - Country:US
Mailing Address - Phone:212-749-4457
Mailing Address - Fax:
Practice Address - Street 1:145 W 96TH ST
Practice Address - Street 2:1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6403
Practice Address - Country:US
Practice Address - Phone:212-749-4457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005502103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical