Provider Demographics
NPI:1720854821
Name:WOODS, AMY M
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
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 1:2018 MAIN STREET RD
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60081-9693
Mailing Address - Country:US
Mailing Address - Phone:815-678-6750
Mailing Address - Fax:
Practice Address - Street 1:2018 MAIN STREET RD
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:IL
Practice Address - Zip Code:60081-9693
Practice Address - Country:US
Practice Address - Phone:815-678-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool