Provider Demographics
NPI:1528430857
Name:WOODROW, LAWRENCE (PHD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:WOODROW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 COFFEEN AVE
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5314
Mailing Address - Country:US
Mailing Address - Phone:307-655-5510
Mailing Address - Fax:307-655-5785
Practice Address - Street 1:632 COFFEEN AVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5314
Practice Address - Country:US
Practice Address - Phone:307-655-5510
Practice Address - Fax:307-655-5785
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist