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NPI Code Detail

MEDICARE: DARRYL WOODS

MEDICARE:   DARRYL  WOODS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1982154282
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARRYL WOODS
Provider Business Mailing Address
First Line : 4960 W 59TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-1104
Country : US
Telephone Number : 317-250-7957
Fax Number :
Provider Business Practice Location Address
First Line : 4960 W 59TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-1104
Country : US
Telephone Number : 317-250-7957
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2016
Last Update Date : 10/11/2016

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Directions to “ DARRYL WOODS ” Practice Location

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