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General NPI Number Information
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NPI Number | 1679239198
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Entity Type | Individual
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Provider Name | MARY LOUISE WOODY PHD
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 4415 5TH AVE STE 160
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City | PITTSBURGH
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State | PA
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Zip | 15213-2654
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Country | US
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Telephone | 412-246-5811
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Fax | 412-246-5815
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Provider Business Mailing Address
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Address Line | 300 LIBERTY AVE APT 215
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City | PITTSBURGH
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State | PA
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Zip | 15222-1271
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Country | US
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Telephone | 412-906-9373
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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 | PS019150
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License Number State | PA
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