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General NPI Number Information
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NPI Number | 1780030544
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Entity Type | Individual
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Provider Name | TONYA MARIE WOODS MS
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Gender | Female
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 762 SCRUB JAY DR
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-1729
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Country | US
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Telephone | 904-446-8428
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Fax | 844-770-0422
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Provider Business Mailing Address
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Address Line | 2220 COUNTY ROAD 210 W STE 108-313
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City | JACKSONVILLE
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State | FL
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Zip | 32259-4058
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Country | US
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Telephone | 904-446-8428
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Fax | 844-770-0422
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH002795
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License Number State | PA
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