Provider Demographics
NPI:1063147692
Name:WOODS, KRISTY NICOLE
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:NICOLE
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 SW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-8139
Mailing Address - Country:US
Mailing Address - Phone:304-942-2237
Mailing Address - Fax:
Practice Address - Street 1:5450 SW 136TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-8139
Practice Address - Country:US
Practice Address - Phone:304-942-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool