Provider Demographics
NPI:1487167276
Name:WOLFE, FARAH (OT)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:FARAH
Other - Middle Name:DAWN
Other - Last Name:FRISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1002 GARDEN LAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2780
Mailing Address - Country:US
Mailing Address - Phone:419-720-3937
Mailing Address - Fax:
Practice Address - Street 1:1002 GARDEN LAKE PKWY
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2780
Practice Address - Country:US
Practice Address - Phone:419-720-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007578225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist