Healthcare Provider Details

I. General information

NPI: 1184956591
Provider Name (Legal Business Name): VIRGINIA BEATRIZ WOODMANCY MS, LMFT, CDC II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIRGINIA BRATRIZ RHODES-WOODMANCY MS, LMFT, CDC II

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SLOUGH VIEW DRIVE
ANIAK AK
99557-0354
US

IV. Provider business mailing address

PO BOX 354
ANIAK AK
99557-0354
US

V. Phone/Fax

Practice location:
  • Phone: 907-675-4633
  • Fax: 907-675-4633
Mailing address:
  • Phone: 907-675-4633
  • Fax: 907-675-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number727204
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: