Provider Demographics
NPI:1205590130
Name:WOHLFORT, KATHLEEN (MS)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:WOHLFORT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:LYME
Mailing Address - State:NH
Mailing Address - Zip Code:03768-0201
Mailing Address - Country:US
Mailing Address - Phone:603-795-4466
Mailing Address - Fax:
Practice Address - Street 1:19A SLOAN LN
Practice Address - Street 2:
Practice Address - City:LYME
Practice Address - State:NH
Practice Address - Zip Code:03768-3217
Practice Address - Country:US
Practice Address - Phone:603-795-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula