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General NPI Number Information
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NPI Number | 1649613795
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Entity Type | Individual
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Provider Name | THERESA ANN WOODARD PHD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 141 TOWNSHIP AVENUE DOXA COUNSELING STE 303
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City | RICHLAND
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State | MS
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Zip | 39157
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Country | US
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Telephone | 601-228-9806
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Fax | 601-207-8588
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Provider Business Mailing Address
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Address Line | 229 SOUTHWIND DRIVE
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City | RICHLAND
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State | MS
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Zip | 39218
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Country | US
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Telephone | 601-317-9021
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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 | 1705
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License Number State | MS
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