MEDICARE: DR. AMANDA MICHELLE WOODS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY003472	GA

General Provider Information

NPI Number	:	1427346774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA MICHELLE WOODS PH.D.

Provider Business Mailing Address
First Line	:	5400 LAUREL SPRINGS PKWY STE 201
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-6062
Country	:	US
Telephone Number	:	770-570-9193
Fax Number	:

Provider Business Practice Location Address
First Line	:	5400 LAUREL SPRINGS PKWY STE 201
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-6062
Country	:	US
Telephone Number	:	770-570-9193
Fax Number	:	888-339-2833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	12/18/2024

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