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General NPI Number Information
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NPI Number | 1093387243
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Entity Type | Organization
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Legal Business Name | CHRISTINE WOODS, LLC
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 601 E BROADWAY STE 304
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City | COLUMBIA
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State | MO
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Zip | 65201-4469
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Country | US
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Telephone | 573-825-0672
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Fax |
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Provider Business Mailing Address
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Address Line | 5104 CHESAPEAKE LN
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City | COLUMBIA
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State | MO
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Zip | 65202-6422
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Country | US
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Telephone | 573-825-0672
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD THERAPIST
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Name | CHRISTINE WOODS
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Credential | LCSW, EDD
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Telephone | 573-864-3538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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