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General NPI Number Information
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NPI Number | 1356670012
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Entity Type | Individual
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Provider Name | PATRICIA MARIE WOODIN-WEAVER ED.D
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Gender | Female
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 17 SENIOR ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-8534
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Country | US
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Telephone | 732-932-7884
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Fax |
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Provider Business Mailing Address
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Address Line | 64 PHYLDAN RD
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City | EAST HANOVER
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State | NJ
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Zip | 07936-3117
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Country | US
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Telephone | 201-572-1884
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35S100467900
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License Number State | NJ
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