Provider Demographics
NPI:1295861649
Name:WOODSON, PAMELA M (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:WOODSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-4028
Mailing Address - Country:US
Mailing Address - Phone:479-453-0303
Mailing Address - Fax:479-477-5509
Practice Address - Street 1:116 S FRONT ST
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-4028
Practice Address - Country:US
Practice Address - Phone:479-453-0303
Practice Address - Fax:479-477-5509
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical