Healthcare Provider Details
I. General information
NPI: 1336010883
Provider Name (Legal Business Name): ANGEL MARIE WOODEN MS, LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1131 N 35TH AVE FL 2
HOLLYWOOD FL
33021-5403
US
IV. Provider business mailing address
520 S PARK RD APT 12-34
HOLLYWOOD FL
33021-8397
US
V. Phone/Fax
- Phone: 954-265-6319
- Fax: 954-276-0166
- Phone: 321-262-1644
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 170300000X |
| Taxonomy | Genetic Counselor (M.S.) |
| License Number | TGC831 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: