Provider Demographics
NPI:1609464569
Name:WOLFF, SONDRA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SONDRA
Middle Name:
Last Name:WOLFF
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-4634
Mailing Address - Country:US
Mailing Address - Phone:918-227-2010
Mailing Address - Fax:918-227-2843
Practice Address - Street 1:14 S MISSION ST
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4634
Practice Address - Country:US
Practice Address - Phone:918-227-2010
Practice Address - Fax:918-227-2843
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK15135OtherOKLAHOMA STATE BOARD OF PHARMACY