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General NPI Number Information
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NPI Number | 1912087776
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Entity Type | Individual
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Provider Name | LESHELLE D WOODARD PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 11/16/2015
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Provider Practice Location Address
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Address Line | 427 COLUMBIA RD 108
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City | HANOVER
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State | MA
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Zip | 02339-3213
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Country | US
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Telephone | 617-552-5124
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Fax | 888-317-2641
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Provider Business Mailing Address
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Address Line | PO BOX 934
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City | HANOVER
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State | MA
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Zip | 02339
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Country | US
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Telephone | 617-552-5124
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Fax | 888-317-2641
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 8649
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License Number State | MA
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