MEDICARE: GILDA WOODRIDGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		LA

General Provider Information

NPI Number	:	1336676998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILDA WOODRIDGE

Provider Business Mailing Address
First Line	:	924 TRICOU ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-1462
Country	:	US
Telephone Number	:	504-452-4372
Fax Number	:

Provider Business Practice Location Address
First Line	:	924 TRICOU ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-1462
Country	:	US
Telephone Number	:	504-452-4372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2017
Last Update Date	:	07/21/2022

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Directions to “ GILDA WOODRIDGE ” Practice Location

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