Healthcare Provider Details

I. General information

NPI: 1114744117
Provider Name (Legal Business Name): WOVEN THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 VASS CARTHAGE RD
CARTHAGE NC
28327-9214
US

IV. Provider business mailing address

2475 VASS CARTHAGE RD
CARTHAGE NC
28327-9214
US

V. Phone/Fax

Practice location:
  • Phone: 910-639-2545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN ZALE
Title or Position: OWNER
Credential:
Phone: 910-639-2545