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General NPI Number Information
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NPI Number | 1245446442
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Entity Type | Individual
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Provider Name | MARK STEPHEN WOODFORD PH.D., LPC, MAC
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2000 PENNINGTON RD TCNJ, 327 FORCINA HALL
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City | EWING
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State | NJ
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Zip | 08618-1104
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Country | US
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Telephone | 609-771-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 153 PINE LN
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City | YARDLEY
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State | PA
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Zip | 19067-2820
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Country | US
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Telephone | 215-321-7918
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00290700
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License Number State | NJ
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