MEDICARE: DR. JESSICA WOODS PSY.D.

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	103TC0700X	Clinical Psychologist	35SI00614500	NJ

General Provider Information

NPI Number	:	1477109205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA WOODS PSY.D.

Provider Business Mailing Address
First Line	:	2050 VOORHEES TOWN CTR
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-1910
Country	:	US
Telephone Number	:	855-852-8150
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 VOORHEES TOWN CTR
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-1910
Country	:	US
Telephone Number	:	855-852-8150
Fax Number	:

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

Provider Enumeration Date	:	08/16/2019
Last Update Date	:	08/16/2019

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