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General NPI Number Information
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NPI Number | 1306554423
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Entity Type | Individual
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Provider Name | ELIZABETH WOODS
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Gender | Female
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 111 NEWMAN ST
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City | EAST TAWAS
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State | MI
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Zip | 48730-1272
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Country | US
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Telephone | 989-334-4837
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Fax |
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Provider Business Mailing Address
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Address Line | 217 W HUEBER ST
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City | ALPENA
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State | MI
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Zip | 49707-2145
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Country | US
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Telephone | 989-464-5171
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MI
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