Most Relevant Information
Provider Data
| NPI Number: | 1003315938 |
| Provider Name: | JACOB DYLAN WOLFE LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 121045 |
Most Important Dates
| Enumeration Date: | 02/06/2018 |
| Last Updated: | 11/01/2019 |
Provider Practice Location
1493 CAMBRIDGE ST
CAMBRIDGE
MA
021391047
Practice Location Phone/Fax
| Phone: | 6176651646 |
| Fax: |
Provider Mailing Location
1493 CAMBRIDGE ST
CAMBRIDGE
MA
021391099
Provider Mailing Phone/Fax
| Phone: | 6176652368 |
| Fax: |