Provider Demographics
NPI:1427348267
Name:WOODSON, MILO
Entity type:Individual
Prefix:
First Name:MILO
Middle Name:
Last Name:WOODSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1536
Mailing Address - Country:US
Mailing Address - Phone:303-443-9567
Mailing Address - Fax:
Practice Address - Street 1:2885 AURORA AVE
Practice Address - Street 2:SUITE 9 & 10
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2250
Practice Address - Country:US
Practice Address - Phone:303-245-0916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical