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General NPI Number Information
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NPI Number | 1275390981
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Entity Type | Individual
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Provider Name | LADETRA WOODSON LPC
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Gender | Female
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Dates
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Enumeration Date | 02/29/2024
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 2912 PAINT BRUSH PL
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City | LANCASTER
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State | TX
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Zip | 75134-1673
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Country | US
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Telephone | 214-402-1608
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 N HAMPTON RD STE 425
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City | DESOTO
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State | TX
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Zip | 75115-2491
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Country | US
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Telephone |
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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 | 89243
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License Number State | TX
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