1184956591 NPI number — VIRGINIA BEATRIZ WOODMANCY MS, LMFT, CDC II

Table of content: VIRGINIA BEATRIZ WOODMANCY MS, LMFT, CDC II (NPI 1184956591)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184956591 NPI number — VIRGINIA BEATRIZ WOODMANCY MS, LMFT, CDC II

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOODMANCY
Provider First Name:
VIRGINIA
Provider Middle Name:
BEATRIZ
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LMFT, CDC II
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RHODES-WOODMANCY
Provider Other First Name:
VIRGINIA
Provider Other Middle Name:
BRATRIZ
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, LMFT, CDC II
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184956591
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 354
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANIAK
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99557-0354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-675-4633
Provider Business Mailing Address Fax Number:
907-675-4633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 SLOUGH VIEW DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANIAK
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99557-0354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-675-4633
Provider Business Practice Location Address Fax Number:
907-675-4633
Provider Enumeration Date:
02/10/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  727204 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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