Basic Information
| Provider Information | |||||||||
| NPI: | 1518046721 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOODS | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | ANNETTE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LGSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MANN | ||||||||
| OtherFirstName: | KRISTEN | ||||||||
| OtherMiddleName: | ANNETTE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LGSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2868 ACTON ROAD | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059688360 | ||||||||
| FaxNumber: | 2059688373 | ||||||||
| Practice Location | |||||||||
| Address1: | 2868 ACTON ROAD | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059688360 | ||||||||
| FaxNumber: | 2059688373 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 2057G | AL | X | Behavioral Health & Social Service Providers | Counselor | 2084P0800X | 2057G | AL | X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.