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NPI 1346481900

NPI 1346481900 : ANTOINETTE WOODS LPC : TALLULAH, LA

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General NPI Number Information
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    NPI Number           |    1346481900
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    Entity Type          |    Individual 
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    Provider Name        |    ANTOINETTE WOODS LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/11/2009
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    Last Update Date     |    08/05/2016
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Provider Practice Location Address
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    Address Line         |    1705 FELICIA AVE 
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    City                 |    TALLULAH
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    State                |    LA
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    Zip                  |    71282-8203
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    Country              |    US
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    Telephone            |    318-574-1232
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1705 FELICIA DRIVE 
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    City                 |    TALLULAH
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    State                |    LA
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    Zip                  |    71282
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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       |    6032
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    License Number State |    LA
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