Provider Demographics
NPI:1164995635
Name:WOODSON, TRUDY (BA CAP)
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:
Last Name:WOODSON
Suffix:
Gender:F
Credentials:BA CAP
Other - Prefix:
Other - First Name:TRUDY
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 FIR RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-2184
Mailing Address - Country:US
Mailing Address - Phone:321-287-5713
Mailing Address - Fax:
Practice Address - Street 1:31 FIR RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-2184
Practice Address - Country:US
Practice Address - Phone:321-287-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)