| Wolff Pac | |
|
3505 Embassy Pkwy Ste 100 Fairlawn OH 44333-8403 | |
| (330) 271-6107 | |
| (330) 706-4705 |
| Full Name | Wolff Pac |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3505 Embassy Pkwy Ste 100, Fairlawn, Ohio |
| Authorized Official Name and Position | Kim Phan Wolff (CEO & FOUNDER) |
| Authorized Official Contact | 3302716107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wolff Pac 3505 Embassy Pkwy Ste 100 Fairlawn OH 44333-8403 Ph: (330) 271-6107 | Wolff Pac 3505 Embassy Pkwy Ste 100 Fairlawn OH 44333-8403 Ph: (330) 271-6107 |
| NPI Number | 1750979233 |
|---|---|
| Provider Enumeration Date | 01/09/2021 |
| Last Update Date | 08/18/2021 |
| Certification Date | 08/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750979233 | NPI | - | NPPES |
| 0433777 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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