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Physician Compare National (NPI:1912087776)

HEALTHCARE PROVIDER: LESHELLE D WOODARD PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1912087776
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5597765693
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20091002000510
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name WOODARD
Individual professional last name
Provider First Name LESHELLE
Individual professional first name
Provider Middle Name D
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2001
Individual professional's medical school graduation year
Primary Specialty PSYCHOLOGIST, CLINICAL
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 427 COLUMBIA RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 108
Group Practice or individual's line 2 address
City HANOVER
Group Practice or individual's city
State MA
Group Practice or individual's state
Zip Code 023393213
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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