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1780030544 NPI number — TONYA MARIE WOODS MS

NPI Number: 1780030544
Health Care Provider/Practitioner: TONYA MARIE WOODS MS

Information about “1780030544” NPI (TONYA MARIE WOODS MS) exists in 1780030544 in HTML format HTML  |  1780030544 in plain Text format TXT  |  1780030544 in PDF (Portable Document Format) PDF  |  1780030544 in an XML format XML  formats.

NPI Number : 1780030544 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780030544",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WOODS",
    "FirstName": "TONYA",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MARSTELLER",
    "OtherFirstName": "TONYA",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2220 COUNTY ROAD 210 W STE 108-313",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32259-4058",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "904-446-8428",
    "MailingAddressFaxNumber": "844-770-0422",
    "FirstLinePracticeLocationAddress": "762 SCRUB JAY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ST AUGUSTINE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32092-1729",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-446-8428",
    "PracticeLocationAddressFaxNumber": "844-770-0422",
    "EnumerationDate": "05/11/2016",
    "LastUpdateDate": "01/18/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": "BH002795",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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