Provider Demographics
NPI:1356084990
Name:WOODS, KIERSTEN
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:
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 1:2825 W TOWN CENTER CIR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3734
Mailing Address - Country:US
Mailing Address - Phone:281-570-2420
Mailing Address - Fax:
Practice Address - Street 1:2825 W TOWN CENTER CIR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3734
Practice Address - Country:US
Practice Address - Phone:281-570-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician