Healthcare Provider Details

I. General information

NPI: 1871287177
Provider Name (Legal Business Name): LATASHIA WOODS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 NORTH BRADDOCK AVENUE PITTSBURGH
PITTSBURGH PA
15208
US

IV. Provider business mailing address

33 NORTH BRADDOCK AVENUE
PITTSBURGH PA
15208-1261
US

V. Phone/Fax

Practice location:
  • Phone: 412-864-5004
  • Fax:
Mailing address:
  • Phone: 412-864-5004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: