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NPI Code Detail

MEDICARE: MS. CAROL J. WOODBURY M.ED.

MEDICARE: MS. CAROL J. WOODBURY M.ED.
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
1106H00000XMarriage & Family Therapist0274MN

General Provider Information

NPI Number : 1538252325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL J. WOODBURY M.ED.
Provider Business Mailing Address
First Line : 5200 WILLSON RD STE 150
Second Line :
City : EDINA
State : MN
Zip : 55424-1300
Country : US
Telephone Number : 952-767-0539
Fax Number : 952-767-0578
Provider Business Practice Location Address
First Line : 5200 WILLSON RD STE 150
Second Line :
City : EDINA
State : MN
Zip : 55424-1300
Country : US
Telephone Number : 952-767-0539
Fax Number : 952-767-0578
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 04/16/2024

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