Healthcare Provider Details

I. General information

NPI: 1407120397
Provider Name (Legal Business Name): ELIZABETH L. WOIDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2012
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 ARSENAL AVE STE 202
FAYETTEVILLE NC
28305-5398
US

IV. Provider business mailing address

901 ARSENAL AVE STE 202
FAYETTEVILLE NC
28305-5478
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-3368
  • Fax: 910-486-7000
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: