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General NPI Number Information
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NPI Number | 1780191163
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Entity Type | Organization
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Legal Business Name | DR WOODS PSYCHOLOGY
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Dates
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Enumeration Date | 01/07/2018
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Last Update Date | 01/07/2018
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Provider Practice Location Address
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Address Line | 1413 S PATRICK DR STE 1
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City | SATELLITE BEACH
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State | FL
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Zip | 32937-4344
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Country | US
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Telephone | 321-209-3115
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 361212
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City | MELBOURNE
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State | FL
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Zip | 32936-1212
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Country | US
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Telephone | 321-209-3115
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. BONNIE SAARI WOODS
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Credential | PHD
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Telephone | 321-704-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PY9874
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License Number State | FL
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