Healthcare Provider Details

I. General information

NPI: 1427993716
Provider Name (Legal Business Name): JASON ROBERT WOODS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 STAHLHEBER RD
HAMILTON OH
45013-1913
US

IV. Provider business mailing address

1325 STAHLHEBER RD
HAMILTON OH
45013-1913
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-5640
  • Fax:
Mailing address:
  • Phone: 513-868-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.00034
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: