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General NPI Number Information
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NPI Number | 1124226618
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Entity Type | Individual
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Provider Name | LISA DENETTE WOODS FAODP
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8809 JOHN C LODGE
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City | DETROIT
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State | MI
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Zip | 48202
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Country | US
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Telephone | 313-887-6736
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 N CAMPBELL ST
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City | DETROIT
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State | MI
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Zip | 48210-2525
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Country | US
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Telephone | 313-898-7820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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