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General NPI Number Information
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NPI Number | 1144525411
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Entity Type | Individual
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Provider Name | VALERIE WOODSON
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Gender | Female
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 401 SE 6TH ST
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City | EVANSVILLE
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State | IN
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Zip | 47713-1217
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Country | US
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Telephone | 812-425-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 5902 W COUNTY ROAD 150 S
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City | ROCKPORT
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State | IN
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Zip | 47635-8402
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Country | US
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Telephone | 812-359-4819
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 32001710A
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License Number State | IN
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